吗啡联合右美托咪定静脉自控镇痛对晚期胃癌难治性癌痛患者生活质量的影响

Effect of morphine combined with dexmedetomidine intravenous controlled analgesia on quality of life in patients with advanced refractory cancer pain in gastric cancer

目的探讨吗啡联合右美托咪定静脉自控镇痛对晚期胃癌难治性癌痛患者生活质量的影响。方法选取2016年3月至2019年3月陆军军医大学第二附属医院收治的晚期胃癌难治性癌痛患者77例,采用随机数表法将其分为观察组(39例)和对照组(38例)。对照组患者采用吗啡静脉自控镇痛,观察组患者采用吗啡联合右美托咪定静脉自控镇痛。比较两组患者镇痛疗效,暴发痛次数和吗啡用量,镇痛前和镇痛后1个月生活质量,以及不良反应发生情况。结果观察组患者镇痛总有效率显著高于对照组(P<0.05)。观察组患者暴发痛次数和吗啡用量均显著少于对照组(均P<0.05)。镇痛后1个月,两组患者日常生活、疲乏状态、精神状态、食欲和睡眠评分均高于镇痛前(均P<0.05),且观察组患者以上评分均显著高于对照组(均P<0.05)。观察组患者不良反应发生率显著低于对照组(P<0.05)。结论吗啡联合右美托咪定静脉自控镇痛对晚期胃癌难治性癌痛患者的镇痛效果良好,且可改善患者生活质量。

Objective To investigate the effect of morphine combined with dexmedetomidine on quality of life in patients with refractory cancer pain of advanced gastric cancer.Method 77 patients with refractory cancer pain of advanced gastric cancer admitted to the Second Affiliated Hospital of Army Medical University from March 2016 to March 2019 were selected and divided into observation group(39 cases)and control group(38 cases)by random number table method.Patients in control group were given morphine intravenous controlled analgesia,while patients in observation group were given morphine combined with dexmede tomidine intravenous controlled analgesia.There were compared of two groups analgesic efficacy,number of outbreaks of pain and morphine dosage,the improvement of quality of life before and 1 month after analgesia,and the occurrence of adverse reactions.Result The total analgesic effective rate of observation group was higher than control group(P<0.05).The number of outbreaks of pain and dosage of morphine in observation group were less than those control group(all P<0.05).One month after analgesia,the scores of daily life,fatigue state,mental state,appetite and sleep of patients in the two groups were all higher than those before analgesia(all P<0.05),and the scores of patients in observation group were significantly higher than those in control group(all P<0.05).The incidence of adverse reactions in observation group was lower than that of control group(P<0.05).Conclusion Morphine combined with dexmedetomidine for intravenous controlled analgesia has a good analgesic effect in patients with refractory cancer pain of advanced gastric cancer,and can improve the quality of life of patients.