不同剂量右美托咪定在晚期肝癌癌痛患者镇痛中的临床研究

Clinical study on Analgesia of Different Doses of Dexmedetomidine in Patients with Advanced Liver Cancer Pain

目的:探讨不同剂量右美托咪定在晚期肝癌癌痛患者镇痛中的应用价值。方法:选取2018年1月-2020年6月中国人民解放军113医院治疗的晚期顽固性癌痛肝癌患者117例,按照随机数字表法分为三组,A组(舒芬太尼2.5μg/kg+右美托咪定1.5μg/kg)、B组(舒芬太尼2.5μg/kg+右美托咪定2.0μg/kg)、C组(舒芬太尼2.5μg/kg+右美托咪定2.5μg/kg),每组39例。三组均采用患者自控静脉镇痛治疗。观察治疗开始后的2、8、24、48及72 h患者的疼痛视觉模拟评分(VAS)、镇痛泵有效按压次数、满意度及不良反应发生情况。结果:A组各时间点的VAS评分高于B、C组,差异有统计学意义(P<0.05);B、C组组间比较,差异无统计学意义(P>0.05)。A组镇痛泵有效按压次数高于B、C组,差异有统计学意义(P<0.05);B、C组组间比较,差异无统计学意义(P>0.05)。B组总满意度高于A、C组,不良反应发生率低于A、C组,差异均有统计学意义(P<0.05)。结论:采用右美托咪定中等剂量进行晚期癌痛患者镇痛,可以达到良好的镇痛效果,减少不良反应的发生,有利于提高患者的满意度。

Objective:To investigate the application value of analgesia of different doses of Dexmedetomidine in patients with advanced liver cancer pain.Method:A total of 117 liver cancer patients with advanced refractory cancer pain in PLA 113 Hospital from January 2018 to June 2020 were selected and divided into 3 groups according to the random number table method,group A(Sufentanil 2.5μg/kg+Dexmedetomidine 1.5μg/kg),group B(Sufentanil 2.5μg/kg+Dexmedetomidine 2.0μg/kg)and group C(Sufentanil 2.5μg/kg+Dexmedetomidine 2.5μg/kg),39 cases in each group.All the patients were treated with patient controlled intravenous analgesia.The visual analogue scale(VAS)of pain score,effective times of pressing the analgesic pump at 2,8,24,48 and 72 hours after treatment,the satisfaction of patients and the occurrence of adverse reactions were observed.Result:The VAS scores of patients in group A at each time points were higher than those in groups B and C,and the differences were statistically significant(P<0.05);there was no significant difference between groups B and C(P>0.05).The effective pressing times of analgesic pump in group A were higher than those in group B and C,and the differences were statistically significant(P<0.05);there were no significant differences between groups B and C(P>0.05).The total satisfaction of group B was higher than that in groups A and C,and the incidence of adverse reactions was lower than those in groups A and C,with statistical significances(P<0.05).Conclusion:Moderate dose of Dexmedetomidine for analgesia in patients with advanced cancer pain can achieve good analgesic effect,reduce the occurrence of adverse reactions,and improve patient satisfaction.