舒芬太尼患者皮下自控镇痛治疗难治性癌痛的临床分析

Clinical Analysis of Sufentanil Patient-controlled Subcutaneous Analgesia for Refractory Cancer Pain

目的判断舒芬太尼皮下自控镇痛对难治性癌痛的疗效。方法 2020年6月—2021年6月征得难治性癌痛者同意后,向研究内纳入98例,按照抽签法分组,镇痛组49例,参考组49例。前者行舒芬太尼皮下自控镇痛,后者行吗啡缓释片口服镇痛。统计镇痛情况,评估应激状态,整理并发症和满意度。结果镇痛前,两组患者VAS、NRS比较,镇痛组和参考组差异无统计学意义(t=0.215、0.651,P=0.830、0.516)。镇痛后,两组患者VAS、NRS比较,镇痛组低于参考组,差异有统计学意义(t=5.054、9.067,P<0.05)。镇痛前,两组患者去甲肾上腺素(NE)、C反应蛋白(CRP)、皮质醇(Cor)比较,镇痛组和参考组差异无统计学意义(t=0.463、0.980、0.577,P=0.644、0.330、0.565)。镇痛后,两组患者NE、CRP、COR比较,镇痛组低于参考组,差异有统计学意义(t=6.680、5.334、15.488,P<0.05)。镇痛组并发症发生率(6.12%)低于参考组(22.45%),差异有统计学意义(χ^(2)=5.333,P=0.021)。镇痛组镇痛满意度(95.92%)高于参考组(79.59%),差异有统计学意义(χ^(2)=6.078,P=0.014)。结论舒芬太尼有较强镇痛效果,经皮下自控镇痛后,可调整镇痛强度,能缓解应激情况,减少并发症,得到癌痛者重视。

Objective To determine the efficacy of sufentanil subcutaneous patient-controlled analgesia for refractory cancer pain. Methods After obtaining the consent of patients with refractory cancer pain from June 2020 to June 2021,98 cases were included in the study. According to the lottery method, 49 cases were in the analgesic group and 49 cases in the reference group. The former was treated with sufentanil subcutaneously controlled analgesia, and the latter was treated with morphine sustained-release tablets for oral analgesia. Statistics of analgesia, assessment of stress state,sorting out complications and satisfaction. Results Before analgesia, compared the two groups of patients with VAS and NRS, there was no statistically significant difference between the analgesic group and the reference group(t =0.215,0.651, P=0.830, 0.516). After analgesia, for the comparison of VAS and NRS between the two groups of patients, the analgesic group was lower than the reference group, and the difference was statistically significant(t=5.054, 9.067, P<0.05). Before analgesia, compared the two groups of patients with norepinephrine(NE), C-reactive protein(CRP), and cortisol(Cor), there was no statistically significant difference between the analgesic group and the reference group(t=0.463, 0.980, 0.577, P =0.644, 0.330, 0.565). After analgesia, NE, CRP, and Cor were compared between the two groups. The analgesic group was lower than the reference group, and the difference was statistically significant(t=6.680,5.334, 15.488, P <0.05). The incidence of complications in the analgesia group(6.12%) was lower than that in the reference group(22.45%), and the difference was statistically significant(χ^(2)=5.3 33, P =0.021). Satisfaction with analgesia in the analgesia group(95.92%) was higher than that in the reference group(79.59%), and the difference was statistically significant(χ^(2)=6.078, P=0.014). Conclusion Sufentanil has a strong analgesic effect. After subcutaneously controlled analgesia, the intensity of analgesia can be adjusted, which can relieve stress and reduce complications. It has been paid attention to by cancer pain patients.