单纯强阿片类药物与腹腔内生场热疗联合强阿片类药物治疗癌痛的效果分析

Comparison of the effects of simple strong opioids and intraperitoneal hyperthermia combined with strong opioids for cancer pain

目的比较分析单纯强阿片类药物与腹腔内生场热疗联合强阿片类药物治疗癌痛的临床效果及安全性。方法收集本院肿瘤科2016年1月至2019年12月间收治的56例经完整病理学或细胞学确诊并伴有癌痛的晚期消化系统肿瘤患者,男34例,女22例,中位年龄60岁,疼痛评分均为中重度疼痛,强阿片类药物选择奥施康定。前7 d单纯使用强阿片类药物治疗癌痛;后7 d使用腹腔内生场热疗,同时联合强阿片类药物治疗癌痛,对癌症患者疼痛评分、爆发性疼痛频率、奥施康定的用量及不良反应状况进行比较分析。结果56例中晚期癌症患者使用腹腔内生场热疗联合强阿片类药物治疗癌痛后,患者的癌痛评分较热疗前有所下降[(4.375±0.728)分比(5.714±0.948)分],7 d内爆发疼痛总次数减少[(4.500±0.991)次比(5.911±1.311)次],使用热疗前后比较差异均有统计学意义(均P<0.0001);使用热疗后奥施康定的每日用量较热疗前减少[(51.786±23.129)mg比(54.643±27.367)mg],差异有统计学意义(均P<0.05);而热疗前后患者的不良反应比较差异均无统计学意义(均P>0.05)。结论腹腔内生场热疗与强阿片类镇痛药物联合使用,能很好地控制晚期癌症患者的疼痛,安全有效地改善患者的生活质量,值得在临床上推广应用。

Objective To compare the clinical effect and safety of simple strong opioids and intraperitoneal hyperthermia combined with strong opioids for cancer pain.Methods A total of 56 patients(34 males,22 females,with the median age of 60 years old)of advanced digestive system tumors with moderate to severe pain confirmed by pathology and cytology in Department of Oncology of our hospital from January 2016 to December 2019 were selected,and strong opioids chose OXYCONTIN.Strong opioid was used only to control cancer pain in the first 7 days,and strong opioid combined with intraperitoneal endogenetic field hyperthermia was used in the next 7 days.The NRS score,paroxysmal pain frequency,dosage of OXYCONTIN,and adverse reactions were compared.Results After treatment of strong opioid combined with intraperitoneal endogenetic field hyperthermia,the NRS score of patients was reduced[(4.375±0.728)points vs.(5.714±0.948)points],the times of paroxysmal pain was reduced[(4.500±0.991)times vs.(5.911±1.311)times],the daily consumption of OXYCONTIN was reduced[(51.786±23.129)mg vs.(54.643±27.367)mg],with statistically significant differences(all P<0.05).But there was no statistically significant difference in adverse reactions before and after hyperthermia(P>0.05).Conclusion Intraperitoneal hyperthermia combined with strong opioids can effectively control the pain of patients with advanced cancer and improve the quality of life of patients safely and effectively.