右美托咪定联合吗啡PCIA对晚期癌痛患者疼痛、负性情绪及生活质量的影响

Effects of Dexmedetomidine Combined Morphine PCIA on Pain,Negative Emotions and Quality of Life in Patients with Advanced Cancer Pain

目的探讨右美托咪定联合吗啡自控静脉镇痛(patient controlled intravenous analgesia,PCIA)对晚期癌痛患者疼痛、负性情绪及生活质量的影响。方法按随机数字表法将2018-09/2020-08月作者医院收治的110例晚期癌痛患者分为对照组(n=55)和研究组(n=55)。对照组给予吗啡PCIA治疗,研究组患者给予右美托咪定联合吗啡PCIA治疗。观察记录两组患者PCIA前及PCIA后3天、1个月的疼痛、焦虑、抑郁、生活质量评分情况。结果研究组与对照组患者疼痛、焦虑、抑郁评分随时间均逐渐降低(P均<0.05),且同一时间点比较PCIA前两组疼痛、焦虑、抑郁评分比较差异无统计学意义(P>0.05),PCIA后3天、1个月研究组疼痛、焦虑、抑郁评分均低于对照组(P均<0.05)。研究组与对照组患者生活质量评分随时间逐渐升高(P<0.05),且同一时间点比较PCIA前研究组与对照组生活质量评分比较差异无统计学意义(P>0.05),PCIA后3天、1个月研究组生活质量评分高于对照组(P均<0.05)。研究组患者镇痛有效率、满意度均明显高于对照组(P均<0.05);研究组患者PCIA后并发症发生率明显低于对照组(25.45%vs.50.90%),吗啡剂量明显少于对照组(P<0.05)。结论右美托咪定联合吗啡PCIA能够有效缓解晚期癌痛患者疼痛,改善负性情绪,降低不良反应,同时提高生活质量。

Objective To investigate the effect of dexmedetomidine combined morphine patient controlled intravenous analgesia(PCIA)on pain,negative emotions and quality of life in patients with advanced cancer pain.Methods A total of 110 patients with advanced cancer pain in author′s hospital from September 2018 to August 2020 were selected as the research subjects,which were randomly divided into control group(n=55)and study group(n=55).The control group was given morphine PCIA,and the study group was given dexmedetomidine combined morphine PCIA.The pain,anxiety,depression and quality of life scores of the two groups before 3 days and 1 month after PCIA were observed and compared.Results The pain,anxiety and depression scores of the study group and the control group gradually decreased over time(all P<0.05),and there was no significant difference in the pain,anxiety and depression scores between the two groups before PCIA at the same timing(P>0.05).After 3 days and 1 month of PCIA,the pain,anxiety and depression scores of the study group were lower than those of the control group(all P<0.05).The quality of life scores of the patients in the study group and the control group gradually increased over time(P<0.05),and at the same timing,there was no significant difference in the quality of life score between the study group and the control group before PCIA(P>0.05).After 3 days and 1 month of PCIA,the quality of life scores of the study group were higher than those of the control group(all P<0.05).The effective rate and satisfaction of analgesia in the study group were significantly higher than those in the control group(all P<0.05).The incidence of complications after PCIA in the study group was significantly lower than that in the control group(25.45%vs.50.90%),and the morphine dose was significantly lower than that in control group(P<0.05).Conclusion Dexmedetomidine combined morphine PCIA can effectively relieve the pain degree of patients with advanced cancer pain,improve the negative emotions,reduce adverse reactions and improve the quality of life of patients.