舒芬太尼腰硬联合在重症癌痛患者治疗的临床应用效果研究

Research on Clinical Application Effect of Combined Spinal and Epidural of Sufentanil in Severe Patients with Cancer Pains

目的探讨与分析对重症癌痛患者给予舒芬太尼腰硬联合方法治疗的效果。方法选择该院自2016年6月—2018年2月收治的住院晚期癌痛患者共72例,按照随机的原则,分成观察组与对照组,对照组患者仅给予单纯的硬膜外镇痛,对于观察组患者,则进行腰硬联合进行治疗,然后观察和统计两组患者治疗以前、用药以后30 min,以及持续性和暴发性VAS评分与治疗的总体满意度(GSS)评价。结果观察组患者在治疗以前和用药以后30 min和持续性VAS评分值分别为(9.0±0.8)分、(2.1±1.2)分和(2.9±1.4)分,与对照组对比,差异无统计学意义(P>0.05),而观察组患者的暴发性VAS评分为(6.0±1.9)分,明显低于对照组患者,两组的暴发性VAS评分值对比,差异有统计学意义(P<0.05);经治疗,观察组患者的总满意度为83.3%,明显高于对照组(61.1%),两组的总满意度对比,差异有统计学意义(χ~2=8.561,P<0.05)。结论对于重症晚期癌痛患者,采用舒芬太尼腰硬联合的治疗方法,能够使得患者的暴发痛VAS评分值大幅降低,且使得患者治疗的总体满意度大幅提升,所以非常值得在临床上加以推广和运用。

Objective To study and analyze the effect of combined spinal and epidural of sufentanil in severe patients with cancer pains. Methods 72 cases of inpatients with advanced cancer pains admitted and treated in our hospital from June 2016 to February 2018 were selected and randomly divided into two groups, the control group only used the simple thoracic epidural analgesia, while the observation group were treated with combined spinal and epidural, and the continuous and fulminant VAS scores and total satisfactory degree before treatment and in 30 min after medication of the two groups were observed and counted. Results The continuous VAS scores before treatment and in 30 min after medication in the observation group were respectively（9.0 ±0.8）points,（2.1 ±1.2）points,（2.9 ±1.4）points, and the differences between groups were not statistically significant（P〈0.05）, and the fulminant VAS score in the observation group was（6.0±1.9）points, which was obviously lower than that in the control group, and the difference in the fulminant VAS score between the two groups was statistically significant（P〈0.05）, after treatment, the total satisfactory degree in the observation group was obviously higher than that in the control group（83.3% vs 61.1%）, and the difference was obvious, with statistical significance（χ2=8.561, P〈0.05）. Conclusion The combined spinal and epidural of sufentanil in severe patients with cancer pains can greatly decrease the fulminant VAS score, and greatly improve the total satisfactory degree, therefore, it is worth clinical promotion and application.