盐酸羟考酮缓释片联合右美托咪定静脉自控镇痛对肺癌难治性癌痛患者生活质量的影响

Effects of oxycodone hydrochloride prolonged-release tablets combined with dexmedetomidine patient controlled intravenous analgesia on the quality of life of patients with refractory cancer pain of lung cancer

目的分析盐酸羟考酮缓释片联合右美托咪定静脉自控镇痛对肺癌难治性癌痛患者生存质量的影响。方法选取2017年3月至2019年3月四川省肿瘤医院收治的166例肺癌难治性癌痛患者纳入本研究。使用随机数字表法将入选患者分为观察组和对照组,每组各83例。两组患者均给予盐酸羟考酮缓释片口服镇痛,观察组患者加用右美托咪定静脉自控镇痛。比较两组患者的镇痛效果、不良反应发生情况和生活质量。结果两组患者入组后各时间点疼痛数字评分量表(numeric rating scale,NRS)评分均显著低于本组入组时(均P<0.05),Karnofsky功能状态(Karnofsky performance status,KPS)评分均显著高于本组入组时(均P<0.05);观察组患者入组后各时间点NRS评分均显著低于同期对照组(均P<0.05),入组10 d、20 d、30 d KPS评分均高于同期对照组(均P<0.05)。两组患者入组1 d Ramsay评分和镇痛期间不良反应发生率比较差异均无统计学意义(均P>0.05)。两组患者入组2 d、10 d、20 d、30 d镇痛有效率均显著高于本组入组1 d(均P<0.05),观察组患者入组1 d、2 d、10 d、20 d、30 d镇痛有效率均显著高于同期对照组(均P<0.05)。结论在盐酸羟考酮缓释片的基础上联合右美托咪定静脉自控镇痛,能够有效缓解肺癌难治性癌痛患者疼痛,改善其生活质量,且安全性良好。

Objective To analyze the effects of oxycodone hydrochloride prolonged-release tablets combined with dexmedetomidine patient controlled intravenous analgesia on the quality of life of patients with refractory cancer pain of lung cancer.Method From March 2017 to March 2019,166 patients with refractory cancer pain of lung cancer admitted to Sichuan Cancer Hospital were included in the study.Patients were divided into observation group and control group by random number table method,with 83 cases in each group.Both groups of patients were given oral analgesia with oxycodone hydrochloride prolonged-release tablets,and patients in observation group were given dexmedetomidine patient controlled intravenous analgesia.The analgesic effects,adverse reactions and quality of life of the two groups were compared.Result After inclusion,the pain numeric rating scale(NRS)scores of the two groups were significantly lower than those when the patients were included in the group(all P<0.05),and the Karnofsky performance status(KPS)scores were significantly higher than those when the patients were included in the group(all P<0.05).The NRS scores of patients in observation group at each time points after entering the group were significantly lower than those of control group at the same period(all P<0.05),and the KPS scores of patients in observation group on the 10 days,20 days and 30 days of entering the group were higher than those of control group at the same period(all P<0.05).There were no significant differences in Ramsay score on the first day of inclusion and the incidence of adverse reactions during analgesia between the two groups(all P>0.05).The effective rates of analgesia on the 2 days,10 days,20 days and 30 days of treatment in the two groups were significantly higher than those on the 1 day of treatment(all P<0.05).The analgesic effective rates of patients in observation group on the 1 day,2 days,10 days,20 days and 30 days of treatment were significantly higher than those in control group at the same period(all P<0.05).Conclusion On the basis of oxycodone hydrochloride prolonged-release tablets combined with dexmedetomidine patient controlled intravenous analgesia,it can effectively relieve the pain of patients with refractory cancer pain of lung cancer,improve their quality of life,and has good safety.