鞘内泵注吗啡复合右美托咪定对重度癌痛晚期结直肠癌患者镇痛效果的影响

    The Effect of Intrathecal Injection of Morphine Combined With Dexmedetomidine on the Analgesic Effect in Patients With Severe Advanced Colorectal Cancer

    • 摘要: 目的 探讨鞘内泵注吗啡复合右美托咪定对重度癌痛晚期结直肠癌患者镇痛效果的影响。 方法 选取2018年12月至2019年12月于重庆市云阳县人民医院确诊重度癌痛晚期结直肠癌患者112例,依据随机表分为吗啡组(n=56)和联合组(n=56),吗啡组给予鞘内泵注吗啡治疗,联合组在此基础上复合右美托咪定治疗,比较两组镇痛效果视觉模拟评分法(visual analog scale,VAS)、炎症反应白介素6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、吗啡用量、不良反应。 结果 吗啡组和联合组治疗1 d、3 d、7 d后VAS评分、IL-6、TNF-α明显低于治疗前,联合组治疗1 d、3 d、7 d后VAS评分、IL-6、TNF-α、吗啡日用量及不良反应率均明显低于吗啡组(全部P<0.05)。 结论 鞘内泵注吗啡复合右美托咪定可有效改善重度癌痛晚期结直肠癌患者镇痛效果及炎症反应,有利于减少吗啡用量及不良反应,值得临床推广。

       

      Abstract: Objective To discuss the effect of intrathecal injection of morphine combined with dexmedetomidine on the analgesic effect in patients with severe cancer pain advanced colorectal cancer. Methods 112 patients with severe cancer pain advanced colorectal cancer in Chongqing Yunyang People's Hospital were selected from December 2018 to December 2019, they were randomly divided into the morphine group (n=56) and combined group (n=56). The morphine group was treated with intrathecal injection of morphine, the combined group was treated with intrathecal injection of morphine combined with dexmedetomidine. The analgesic effect visual analog scale (VAS), inflammatory response interleukin- 6 (IL-6), tumor necrosis factor-α (TNF-α), morphine dosage and adverse reactions were compared between the two groups. Results The VAS score, IL-6 and TNF-α in the morphine group and the combined group after 1 day, 3 days and 7 days of treatment were significantly lower after treatment initiated. The VAS score, IL-6, TNF-α, the daily dosage of morphine and the incidence of adverse reactions in the combined group were all significantly lower than that in the morphine group (all P<0.05). Conclusions Intrathecal injection of morphine combined with dexmedetomidine can effectively improve the analgesic effect and inflammatory response of patients with severe cancer pain advanced colorectal cancer, and it was helpful to reduce the dosage of morphine and incidence of adverse reactions, it's worthy for further clinical promotion.

       

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