英太青、杜冷丁对膀胱癌术后痉挛性疼痛的干预效果比较

Comparison of the intervention effects of diclofenac sodium suppository and dolantin in spasmodic pain after surgery for bladder cancer

目的比较分析英太青、杜冷丁对膀胱癌术后痉挛性疼痛的干预效果。方法以我院2013年2月至2015年2月收治的64例膀胱癌术后痉挛性疼痛患者为研究对象,随机双盲法将患者分为A组与B组各32例,A组患者采取英太青100 mg直肠给药,B组患者则行杜冷丁肌肉注射,比较两组用药后疼痛缓解时间及不良反应情况。结果 A组用药后24 h疼痛次数、VAS评分分别为(4.73±2.15)次、(1.82±0.36)分,较B组的(6.58±2.64)次、(2.04±0.41)分差异有统计学意义(P<0.05)。A组30 min内、30 min至4 h疼痛缓解率分别为18.75%、59.38%,较B组的59.38%、28.12%差异有统计学意义(P<0.05)。两组平均导尿管拔除时间及住院时间比较差异无统计学意义(P>0.05)。两组不良反应发生率比较差异有统计学意义(P<0.05)。结论杜冷丁肌肉注射相比英太青直肠给药起效快,但维持镇痛效果较差,同时英太青直肠给药有效避免胃肠道不良反应发生,临床建议根据膀胱性痉挛疼痛情况确定用药。

Objective To compare and analyze the intervention effects of diclofenac sodium suppository and dolantin in spasmodic pain after surgery for bladder cancer.Methods 64 patients with spasmodic pain after surgery for bladder cancer who were admitted in our hospital between February 2013 and February 2015 were treated as the study object and were randomly divided into group A and B by randomized and double blind method with 32 cases in each group.Group A were treated by rectal administration of 100 mg diclofenac sodium suppository while group B were treated by intramuscular injection of dolantin.The pain relief time and adverse reactions in the two groups after medication were compared.Results The times of 24 h pain and VAS score of group A after medication were(4.73±2.15) times and(1.82±0.36),respectively while those of group B were(6.58±2.64) times and(2.04±0.41) respectively(P < 0.05).The pain relief rates in group A in 30 min and 30 min ~ 4 h were18.75% and 59.38% respectively while those in group B were 59.38% and 28.12% respectively(P < 0.05).There were no significant differences in average time of catheter removal and hospitalization time between the two groups(P > 0.05).There was significant difference in the incidence of adverse reactions between the two groups(P <0.05).Conclusions Intramuscular injection of dolantin takes effect more quickly than rectal administration of diclofenac sodium suppository but the effect of maintaining analgesia is poor.Meanwhile,rectal administration of diclofenac sodium suppository effectively avoid the incidence of gastrointestinal adverse reactions.It is clinically suggested that medication be determined according to the condition of bladder spasmodic pain.