酒石酸布托啡诺对晚期鼻咽癌患者的镇痛效果观察

Analgesic effect of butorphanol tartrate on patients with advanced nasopharyngeal carcinoma

目的 探讨酒石酸布托啡诺经鼻给药用于鼻咽癌晚期患者放疗后的镇痛效果及不良反应。方法 纳入接受放射治疗的鼻咽癌晚期患者160例,随机分为酒石酸布托啡诺鼻喷组(BT组)和3个自控静脉镇痛(PCIA)对照组,分别为布托啡诺组(NB组)、曲马多组(NT组)和安慰剂生理盐水组(NS组)。比较各组患者的镇痛起效时间、镇痛时间、镇痛效果(VAS法)、体力状况(KPS评分)、生活质量(QOL)、不良反应发生等情况。结果 BT组镇痛起效时间(8.54±1.60)min,镇痛时间(11.34±3.20)h,与对照组比较,差异有统计学意义(P<0.05);4组患者在接受治疗6h后,BT组患者VAS评分与对照组比较,差异有统计学意义(P<0.05),治疗后BT组KPS评分与NB组、NT组比较,差异有统计学意义(P<0.05);治疗后BT组生活质量与NB组、NT组、NS组比较,差异有统计学意义(P<0.05)。结论 酒石酸布托啡诺鼻喷剂对鼻咽癌晚期患者自控镇痛有较好的效果,可明显改善患者的体力状况和生活质量,不良反应发生率低,具有临床应用价值。

Objective To investigate the analgesic effects and adverse reactions of butorphanol tartrate administered transnasally in patients with advanced nasopharyngeal carcinoma after radiotherapy.Methods One hundred and sixty patients with advanced nasopharyngeal carcinoma receiving radiotherapy were included.The random number method was used to divide the group into the butorphanol tartrate nasal spray group(BT group) and three PCIA control groups: butoranol group(NB group),tramadol group(NT group) and placebo normal saline group(NS group).The average analgesic onset time, average analgesic time, analgesic effect(VAS method),physical status(KPS score),quality of life(QOL) and the incidence of adverse reactions were compared among the four groups.Results The mean onset time of analgesia in BT group was(8.54±1.60)min, and the mean time of analgesia in BT group was(11.34±3.20)h, which showed significant difference compared with control group(P<0.05).After 6 hours of treatment, the VAS score of BT group was significantly different from that of control group(P<0.05);After treatment, the KPS score of BT group was significantly different from that of NB group and NT group(P<0.05);After treatment, the quality of life of the BT group was significantly different from that of the NB group, NT group and NS groups(P<0.05).Conclusion Butorphanol tartrate nasal spray is effective for patient-controlled analgesia in patients with advanced nasopharyngeal carcinoma, and can significantly improve the physical condition and quality of life of patients, with a low incidence of adverse reactions, and has clinical application value.