氢吗啡酮与吗啡在癌痛治疗中静脉PCA滴定效果比较

Comparison of clinical effects of intravenous PCA titrations between hydromorphone and morphine in the treatment of cancer pain

目的分析氢吗啡酮与吗啡静脉自控镇痛(PCA)滴定用于癌痛治疗中的临床效果。方法选取2018年1月~2019年1月收治的88例癌痛患者为研究对象,随机分为观察组和对照组,各44例,两组患者分别使用氢吗啡酮与吗啡静脉PCA滴定,对比两组患者治疗前、治疗后4 h、8 h、16 h和24 h等不同时间段疼痛数字评分(NRS)及镇静评分,观察两组不良反应发生情况和简易健康状况评定量表(SF-36)变化。结果两组治疗前、治疗后4 h、8 h和16 h NRS评分无明显变化(P>0.05);两组治疗后24 h NRS评分观察组低于对照组(P<0.01)。两组不同时间段镇静效果对比差异无统计学意义(P>0.05);两组不良反应发生率差异无统计学意义(P>0.05);两组SF-36评分对比差异无统计学意义(P>0.05)。结论氢吗啡酮与吗啡静脉PCA滴定在癌痛治疗中均具有良好的镇痛效果,且不良反应发生率和SF-36相当,但氢吗啡酮在作用时间上有一定优势,临床上可予以优先考虑。

Objective To analyze the clinical effects of hydromorphone and morphine intravenous patient controlled analgesia(PCA)titrations in the treatment of cancer pain.Methods 88 patients with cancer pain treated from January 2018 to January 2019 were randomly divided into observation group and control group,with 44 cases in each group.The two groups were given hydromorphone and morphine intravenous PCA titrations,respectively.And then,numerical rating scale(NRS)and sedation score were compared between the two groups before treatment,and 4 h,8 h,16 h and 24 h after treatment,and the occurrence of adverse reactions and the changes of simple health status assessment scale(SF-36)were observed.Results There was no significant change in NRS score before treatment and 4 h,8 h and 16 h after treatment(P>0.05),and 24 h after treatment,the NRS score of the observation group was lower than that of the control group(P<0.01).There was no statistically significant difference in sedative effects between the two groups at different time periods(P>0.05),and there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).In addition,and there was no statistically significant difference in the SF-36 scores between the two groups(P>0.05).Conclusion Both hydromorphone and morphine intravenous PCA titrations have good analgesic effects in the treatment of cancer pain,the incidence of adverse reactions and SF-36 score are comparable,but hydromorphone has some advantages in the time of action,which can be given priority in clinical practice.