胃癌术后应用盐酸羟考酮控释片直肠给药联合硬膜外自控镇痛的临床观察

Effects of patient controlled epidural analgesics combined with rectal administration of oxycodone hydrochloride controlled-release tablets on postoperative gastric cancer patients

目的:探讨盐酸羟考酮控释片(商品名:奥施康定,oxycontin)直肠给药联合硬膜外自控镇痛(PCEA)用于胃癌术后镇痛的疗效以及安全性。方法:将100例胃癌患者随机分为4组,A组采用PCEA镇痛,B组采用PCEA+盐酸羟考酮控释片塞肛镇痛,C组采用盐酸羟考酮控释片塞肛镇痛,D组采用半量PCEA及盐酸羟考酮控释片塞肛镇痛。观察记录各组患者的术后镇痛效果、肠鸣音恢复情况、肛门排气时间,以及恶心、呕吐和便秘等不良反应。结果:4组镇痛效果满意率的差异有统计学意义,P=0.011;B、D两组镇痛效果满意度高于A、C两组;4组肛门排气时间之间的差异有统计学意义,P<0.05;C、D两组的肛门排气时间短于A、B两组,P<0.05。结论:半量的盐酸羟考酮控释片联合PCEA用于胃癌术后镇痛效果可靠,且对肠功能恢复无明显影响。

OBJECTIVE：To investigate the effects of patient-controlled epidural analgesia（PCEA）combined with rectal administration of oxycodone hydrochloride controlled-release tablets on patients with postoperative gastric ancer.METHODS：One hundred patients with operable gastric cancer were randomly divided into four groups,PCEA was used for analgesia for patients in group A,PCEA combined with rectal administration of oxycontin for group B,rectal administration of oxycontin for group C,and semis PCEA and rectal administration of oxycontin for group D.Pain scores graded by visual analog scale（VAS）,the time for intestinal function recovery,and side effects were recorded.RESULTS：The analgesics effects were significantly different in the four groups（P=0.011）.Analgesia effects were more satisfactory in group B and D than those in group A and C（P〈0.05）.The time for intestinal function recovery was shorter in group C and D than those in group A and B（P〈0.05）.CONCLUSION：The semis PCEA and rectal administration of oxycontin is effective and safe in postoperative gastric cancer,with less influence in intestine function.