鞘内吗啡泵联合无线自控镇痛泵对于晚期癌痛患者的疗效及对T淋巴细胞亚群和NK细胞的影响

Efficacy of Intrathecal Morphine Pump Combined with Wireless Self-control Analgesic Pump for Patients with Advanced Cancer Pain and Its Effect on T Lymphocyte Subsets and NK Cells

目的研究鞘内吗啡泵联合无线自控镇痛泵对于晚期癌痛患者的疗效及对T淋巴细胞亚群和自然杀伤细胞(NK)的影响。方法选取130例晚期癌痛患者为研究对象,常规药物止痛的65例患者作为对照组,鞘内吗啡泵联合无线自控镇痛泵止痛的65例患者作为观察组。比较2组患者止痛效果,治疗前、后的T淋巴细胞亚群和NK细胞水平,生活质量,不良反应。结果治疗后观察组数字疼痛评分(NRS)显著低于对照组,并且重度疼痛患者比例明显低于对照组,组间差异均有统计学意义(P<0.05)。治疗前2组患者的T淋巴细胞亚群和NK细胞水平差异无统计学意义(P>0.05),治疗后2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)以及NK细胞水平较治疗前均明显提高(P<0.05)、CD8^(+)水平较治疗前显著下降,并且观察组较对照组的改善更为显著,差异均有统计学意义(P<0.05)。治疗前2组生活质量评分(QOL)差异无统计学意义(P>0.05),治疗后观察组QOL评分显著高于对照组,并且生活质量满意率显著高于对照组(P<0.05),差异均有统计学意义(P<0.05)。观察组、对照组不良反应发生率分别为7.7%、9.2%,组间差异无统计学意义(P>0.05),且2组均无严重不良反应发生。结论鞘内吗啡泵联合无线自控镇痛泵对于晚期癌痛患者疗效满意并且安全性可靠,其镇痛作用显著,能够改善患者的T淋巴细胞亚群和NK细胞水平,从而提高患者免疫功能,改善生活质量。

Objective To investigate the efficacy of intrathecal morphine pump combined with wireless self-control analgesic pump for patients with advanced cancer pain and its effect on T lymphocyte subsets and NK cells.Methods 130 patients with advanced cancer pain were selected as the research object,65 patients were used conventional medication for pain relief as the control group,and 65 patients were used intrathecal morphine pump combined with wireless self-control analgesic pump for pain relief as the observation group.The analgesic effects,T lymphocyte subsets and NK cell levels before and after treatment,quality of life,and adverse reactions of the 2 groups were compared.Results After treatment,the numerical pain score(NRS)of observation group was significantly lower than that of the control group,and the proportion of patients with severe pain was significantly lower than that of the control group,the differences between the 2 groups were statistically significant(P<0.05).There was no significant difference in T lymphocyte subsets and NK cell levels between the 2 groups before treatment(P>0.05),after treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and NK cells were significantly higher than before treatment,and CD8^(+)decreased significantly,the improvement of the observation group was more significant,and the differences were statistically significant compared with the control group(P<0.05).There was no statistically significant difference in the quality of life score(QOL)between the 2 groups before treatment(P>0.05),after treatment,the QOL score of the observation group was significantly higher than that of the control group,and the satisfaction rate of quality of life was significantly higher than that of the control group,the differences were both statistically significant(P<0.05).The incidence of adverse reactions in the observation group and the control group were 7.7%and 9.2%respectively,there was no statistically significant difference between the 2 groups(P>0.05),and no serious adverse reactions occurred in both groups.Conclusion Intrathecal morphine pump combined with wireless self-control analgesic pump has satisfactory efficacy and reliable safety for patients with advanced cancer pain,Its analgesic effect is significant,and it can improve the patient's T lymphocyte subsets and NK cell levels,thereby improving the patient's immune function and quality of life.