加速康复外科模式下药物治疗管理在妇科恶性肿瘤疼痛管理中的应用效果

Application effect of medication therapy management in gynecological malignant tumor pain management under enhanced recovery after surgery model

目的探讨加速康复外科(enhanced recovery after surgery,ERAS)模式下药物治疗管理(medication therapy management,MTM)在妇科恶性肿瘤疼痛管理中的应用效果。方法选取2020年1月至2021年12月萍乡市人民医院收治的92例妇科恶性肿瘤患者作为研究对象,按照随机数字表法分为对照组与观察组,每组46例。对照组给予ERAS模式常规管理,观察组在对照组基础上给予MTM服务。比较两组疼痛缓解率、用药依从性、止痛药物使用情况、阿片类药物不良反应发生情况。结果观察组疼痛缓解率为95.65%,高于对照组的78.26%,差异有统计学意义(P<0.05)。干预后,观察组用药依从性好占比高于对照组,差异有统计学意义(P<0.05)。干预后,观察组强阿片类药物使用率低于对照组,弱阿片类和非甾体类药物使用率均高于对照组,差异有统计学意义(P<0.05)。观察组便秘、呼吸抑制发生率均低于对照组,差异有统计学意义(P<0.05);两组嗜睡、恶心呕吐发生率比较差异无统计学意义。结论ERAS模式下MTM用于妇科恶性肿瘤疼痛管理中效果显著,可调整止痛药物的使用种类,改善患者用药依从性,并缓解其疼痛,减少便秘、呼吸抑制不良反应的发生。

Objective To explore the effect of medication therapy management(MTM)in gynecological malignant tumor pain management under enhanced recovery after surgery(ERAS)model.Methods A total of 92 patients with gynecological malignant tumor admitted to Pingxiang People's Hospital from January 2020 to December 2021 were selected as the research subjects,they were divided into the control group and the observation group according to the random number table method,with 46 cases in each group.The control group was given routine management of ERAS mode,and the observation group was given MTM service on the basis of the control group.The pain relief rate,medication compliance,use of analgesic drugs and adverse reactions of opioids were compared between the two groups.Results The pain relief rate in the observation group was 95.65%,which was higher than 78.26%in the control group,and the difference was statistically significant(P<0.05).After intervention,the proportion of good medication compliance in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After intervention,the utilization rate of strong opioids in the observation group was lower than that in the control group,and the utilization rate of weak opioids and non-steroidal drugs was higher than that in the control group,and the differences were statistically significant(P<0.05).The incidence of constipation and respiratory depression in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05);there were no significant differences in the incidence of drowsiness,nausea and vomiting between the two groups.Conclusion MTM under ERAS model has asignificant effect on pain management of gynecological malignant tumors,it can adjust the types of analgesic drugs,improve patients'medication compliance,relieve their pain,and reduce the occurrence of constipation and respiratory depression.