星状神经节阻滞术治疗肺癌疼痛及对患者生活质量的影响

Effects of stellate ganglion block on the pain and quality of life in patients with lung cancer

目的 探讨星状神经节阻滞对肺癌疼痛及生活质量的影响.方法 将90例肺癌患者根据随机数字表法分为观察组和对照组,对照组采用吗啡10 mg,口服,1次/12 h.观察组采用星状神经节阻滞＋吗啡治疗,对镇痛效果差者以50％剂量逐渐进行加量治疗.比较两组镇痛效果、生活质量及免疫功能变化.结果 治疗后,两组VAS评分均显著降低,且观察组VAS评分降低程度显著优于对照组[（2.5±0.7）分比（3.7±0.9）分],差异有统计学意义（t=7.060,P〈0.05）.观察组镇痛有效率显著高于对照组（91.1％比75.6％）,镇痛持续时间长于对照组（χ^2 =3.920,t=20.681,P〈0.05）.总体吗啡用量,观察组显著低于对照组[（143.5±21.3）mg比（238.7±38.3） mg]（t=14.572,P〈0.05）.治疗后,两组生活质量评分均显著提高,且观察组改善程度明显优于对照组[（86.5±14.3）分比（79.6±15.7）分]（t=2.179,P〈0.05）.治疗后,观察组TGF-β显著降低,且显著低于对照组[（215.4±38.7） pg/mL比（240.5±41.2） pg/mL],差异有统计学意义（t=2.979,P〈0.05）.结论 在肺癌癌性疼痛的治疗中,星状神经节阻滞具有良好的疗效.

Objective To investigate the effect of stellate ganglion block on the pain and quality of life in patients with lung cancer.Methods 90 patients with lung cancer were divided into observation group and control group according to random number table method.The control group was treated with morphine 10mg,orally,1 time/ 12h.The observation group was treated with stellate ganglion block and morphine.For the patients with poor analgesic effect,50% doses were added gradually.The analgesic effect,quality of life and changes of immune function were compared between the two groups.Results After treatment,the VAS scores of the two groups were significantly decreased.And the VAS score reduction in the observation group was significantly better than that in the control group [（2.5 ± 0.7） points vs.（3.7 ± 0.9） points],the difference was statistically significant （t =7.060,P 〈 0.05）.The analgesic efficacy of the observation group was significantly higher than that of the control group（91.1% vs.75.6%,χ^2 =3.920,P 〈 0.05）,the duration of analgesia of the observation group was longer than that of the control group （t =20.681,P 〈 0.05）.For the total morphine dosage method,the observation group was significantly lower than the control group[（143.5 ± 21.3） mg vs.（238.7 ± 38.3） mg] （t =14.572,P 〈 0.05）.After treatment,the scores of quality of life of the two groups were significantly improved,and the improvement degree of the observation group was significantly better than that of the control group [（86.5 ± 14.3） vs.（79.6 ± 15.7）,t =2.179,P 〈 0.05].After treatment,the TGF-beta level of the observation group was significantly reduced,which was significantly lower than that of the control group[（215.4 ± 38.7）pg/mL vs.（240.5 ± 41.2）pg/mL],the difference was statistically signifi cant （t =2.979,P 〈 0.05）.Conclusion Stellate ganglion block has good therapeutic effect in the treatment of lung cancer patients with pain.