超声引导皮下自控镇痛在晚期癌痛患者安宁疗护中的临床应用*

EFFECT OF ULTRASOUND-GUIDED PATIENT-CONTROLLED SUBCUTANEOUS ANALGESIA ON THE HOSPICE CARE OF PATIENTS WITH ADVANCED CANCER PAIN

摘要:

目的 观察超声引导皮下自控镇痛对晚期癌痛患者安宁疗护的临床效果。方法 90例晚期肿瘤患者,分为皮下自控镇痛组(S组)、超声引导皮下自控镇痛组(U组)和静脉自控镇痛组(I组),每组30例。比较治疗前后数字疼痛评分(NRS)、肿瘤患者生活质量评分(QOL)、睡眠质量评分(PSQI),治疗期间不良反应。结果 在治疗前期,I组镇痛效果较好,但在治疗后第7、14d,三组的镇痛效果相同；与I组相比,治疗后第3、7、14d,S组和U组QOL明显提高(P＜0.05)；而且在治疗期间S组和U组PSQI改善效果最明显(P＜0.05),不良反应发生率更低；U组穿刺点皮肤合并症发病率最小,且三组之间的差异均有统计学意义(P＜0.05)。结论 超声引导皮下自控镇痛效果好,不良反应少,安全性高,可以明显改善患者的生活质量和睡眠质量,更适合用于晚期癌痛患者的治疗。

Abstract:

Objective: To observe the clinical effect of ultrasound-guided patient-controlled subcutaneous analgesia on the hospice care of patients with advanced cancer pain. Methods: 90 patients with advanced cancer were divided into three groups: patient-controlled subcutaneous analgesia group (S group), ultrasound-guided patient-controlled subcutaneous analgesia group (U group) and patient-controlled intravenous analgesia group (I group), with 30 cases in each group. The Numeric Rating Score (NRS), Quality of Life score (QOL), Pittsburgh Sleep Quality Index (PSQI) and adverse reactions were compared before and after treatment. Results: In the early stage of treatment, the analgesic effect of I group was the best, but there was no difference among the three groups on the 7th and 14th day after treatment. Compared with I group, the QOL of S group and U group increased significantly on the 3rd, 7th and 14th day after treatment (P＜0.05). During the treatment period, the improvement of PSQI in S group and U group was the most obvious (P＜0.05), and the incidence of adverse reactions was lower. U group had the least incidence rate of skin complications, and the differences among the three groups were statistically significant (P＜0.05). Conclusions: Ultrasound-guided subcutaneous patient-controlled analgesia has a good effect on cancer pain, less adverse reactions, good in security, which can significantly improve the quality of life and sleep quality of patients. It is more suitable for the treatment of patients with advanced cancer pain.