吗啡缓释治疗对肺癌合并难治性呼吸困难患者呼吸功能的影响

Effect of morphine sustained-release therapy on respiratory function in patients with lung cancer complicated by refractory dyspnea

目的探讨吗啡缓释治疗对肺癌合并慢性阻塞性肺疾病(COPD)难治性呼吸困难患者呼吸功能的影响。方法选取2018年8月至2022年3月间西安市北方医院收治的90例肺癌合并COPD难治性呼吸困难患者,采用随机数表法分为对照组和观察组,每组45例。对照组患者接受常规治疗和安慰剂治疗,观察组患者在常规治疗基础上联合吗啡缓释治疗。经4周相应治疗后观察两组患者肺功能、血气指标、运动功能改善情况及不良反应发生率。结果治疗后,观察组第1秒用力呼气容积(FEV)、用力肺活量(FVC)及FEV/FVC、动脉血氧分压(PaO)、动脉血氧饱和度(SaO)、6 min内步行距离(6MWD)高于对照组,动脉血二氧化碳分压(PaCO)及呼吸困难量表(mMRC)评分低于对照组,差异均有统计学意义(均P<0.05)。对照组出现头晕1例,胃肠不适3例,总发生率为8.9%(4/45);观察组出现头晕2例,胃肠不适1例,总发生率为6.7%(3/45),两组比较,差异无统计学意义(P>0.05)。结论吗啡缓释治疗用于肺癌合并COPD难治性呼吸困难患者,可明显提高患者肺功能,改善血气指标,降低炎性反应,促进运动功能更好恢复,安全可行。

Objective To explore the effect of morphine sustained-release therapy on respiratory function in patients with lung cancer complicated with chronic obstructive pulmonary disease(COPD)and refractory dyspnea.Methods A total of 90 patients with lung cancer c complicated with COPD and refractory dyspnea who were treated at Xi’an North Hospital were selected from August 2018 to March 2022.They were divided into an observation group and a control group using the random number table method with 45 patients in each group.The patients in the control group only received conventional treatment plus placebo treatment,and the patients in the observation group received sustained-release morphine treatment in addition to conventional treatment.After 4 weeks of corresponding treatment,the improvement in lung function,blood gas indexes and motor function were observed in the two groups.Results After treatment,the forced expiratory volume in the first second(FEV1)/forced vital capacity(FVC),FEV1,FVC,partial pressure of oxygen(PaO),SaO,and 6-min walk test(6 MWT)were higher in the observation group than in the control group,while PaOand modified medical research council(mMRC)were lower than those in the control group(all P<0.05).Dizziness occurred in 1 patient and gastrointestinal discomfort occurred in 3 patients in the control group,and 2 patients and 1 patient,respectively in the observation group(P>0.05).There was no significant difference in the overall incidence of adverse reactions between the observation group and the control group(2.2%,4/45 versus 6.7%,3/45,P>0.05).Conclusion Morphine sustained-release therapy can significantly improve lung function and blood gas indexes,reduce inflammatory reaction and promote recovery of motor function in patients with lung cancer,COPD and refractory dyspnea.