氢吗啡酮联合右美托咪定治疗临终期病人重度癌痛的临床疗效观察

Clinical observation of hydromorphone combined with dexmedetomidine in the treatment of severe cancer pain in terminal patients

摘要:

目的:探讨氢吗啡酮(PCSA镇痛泵,patient-controlledsubcutaneousanalgesia, PCSA)联合右美托咪定(静脉微量泵泵入)对临终期病人重度癌痛的镇痛效果、焦虑程度及对血清IL-6浓度的影响。方法:采用回顾性研究的方法,选取2020年1月至2022年11月临终期住院病人53例,其中对照组30例,拒绝联合镇静治疗,单纯应用氢吗啡酮镇痛治疗；试验组23例,氢吗啡酮联合右美托咪定镇痛镇静治疗。比较两组治疗前后镇痛效果、焦虑程度及血清IL-6浓度变化。结果:两组病人镇痛治疗后疼痛明显缓解(P<0.05),焦虑程度和血清IL-6浓度较治疗前均有所下降(P<0.05),治疗后试验组焦虑水平和血清IL-6浓度较对照组下降明显(P<0.05),试验组不良反应发生率低于对照组。结论:氢吗啡酮联合右美托咪定治疗临终期病人重度癌痛效果较好,并降低焦虑水平和血清IL-6浓度。

Abstract:

Objective: To explore the analgesic effect of PCSA (Patient-controlled analgesia pump) combined with dexmedetomidine (intravenous micropump) on terminal patients with severe cancer pain, the degree of anxiety and the influence on serum IL-6 concentration. Methods: A retrospective study was conducted to select 53 inpatients in the terminal stage from January 2020 to November 2022, including 30 patients in the control group, who refused to receive combined sedation treatment and only used hydromorphone for analgesia. 23 cases in the experimental group were treated with hydromorphone combined with dexmedetomidine for analgesia and sedation. The analgesic effect, anxiety degree and serum IL-6 concentration of the two groups were compared before and after treatment. Results: After analgesic treatment, the pain in the two groups was obviously relieved (P<0.05), and the anxiety level and serum IL-6 concentration decreased compared with those before treatment (P<0.05). After treatment, the anxiety level and serum IL-6 concentration in the experimental group decreased significantly compared with those in the control group (P<0.05), and the incidence of adverse reactions in the experimental group was lower than that in the control group. Conclusion: Hydromorphone combined with dexmedetomidine is effective in the treatment of severe cancer pain in terminal patients, and it can reduce anxiety level and serum IL-6 concentration.