Pain Management with fentanyl transdermal and morphine subcutaneous injection for the patients with advanced liver cancer pain after intervention therapy
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摘要: 目的 观察芬太尼透皮贴剂联合吗啡皮下注射在晚期肝癌介入术后疼痛护理应用中的优势。 方法 回顾性分析166例晚期肝癌介入治疗后疼痛治疗护理的临床资料，对89例芬太尼联合吗啡治疗组和77例吗啡治疗组在疼痛评分、缓解率两方面数据进行比较，并进行统计学分析；同时记录各组治疗中的副反应。 结果 与吗啡治疗组比较，芬太尼联合组疼痛评分，在12 h（1.97±0.56 vs 3.23±1.49，P<0.05）以及24 h（1.63±0.44 vs 4.19±1.68，P<0.01）均有显著降低。与吗啡治疗组比较，芬太尼联合组介入治疗后疼痛总缓解率，在介入后12 h（92.1% vs 76.6%，P<0.05）以及24 h（97.8% vs 70.1%，P<0.05）均有显著缓解。 结论 晚期肝癌介入治疗后联合使用吗啡皮下注射+芬太尼透皮贴剂外贴治疗，可以显著提高患者介入术后72 h内的疼痛缓解率。Abstract: Objective To evaluate the effects of fentanyl transdermal combined with morphine subcutaneous injection in the management of advanced liver cancer pain after intervention. Methods 166 patients who suffered from advanced liver cancer and received intervention therapy in our hospital were divided into two groups. 89 patients belong to the fentanyl transdermal combined with morphine subcutaneous injection treatment group. 77 patients belong to the morphine subcutaneous injection treatment group. The pain score and the remission rate of the two groups were compared and analyzed statistically. Meanwhile, the side effects of each group were recorded. Results Pain score in the group with fentanyl transdermal and morphine treatment was significantly lower than morphine mono therapy. 12 hours after intervention therapy, (1.97±0.56 for combination treatment vs 3.23±1.49 for morphine only group, P<0.05). 24 hours after intervention therapy, (1.63±0.44 for combination vs 4.19±1.68 for morphine only group, P<0.01). Similarly, the remission rate of the fentanyl transdermal combined with morphine subcutaneous injection group improved significantly, (92.1% vs 76.6% P<0.05) 12 hours after intervention therapy, and(97.8% vs 70.1%, P<0.05) 24 hours after intervention therapy. Conclusions The addition of fentanyl transdermal to morphine subcutaneous injection treatment significantly improve the pain remission rate for the patients with advanced liver cancer pain 72 hours after intervention therapy.
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Key words:
- pain treatment /
- fentanyl transdermal /
- retrospective analysis /
- remission of pain
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[1] Forner A,Llovet JM, Bruix J. Hepatocellular carcinoma[J]. Lancet, 2012, 379(9822):1245-1255. [2] 赵继军,周玲君,崔静,等.疼痛护理学[M].2版.北京:人民军医出版社,2010:24-25. [3] 陈展洪,董敏,李星,等.五个不同分期系统对晚期肝癌患者生存的预测价值比较[J]. 中华肝脏外科手术学电子杂志,2013,4(4):95-100. [4] Radbruch L,Elsner F.Clinical experience with transdermal fentanyl for the treatment of cancer pain in Germany[J].Keio J Med,2004,53(1):23-29. [5] 杨扬,李婕,王守慧,等. 阿片类未耐受患者芬太尼静脉自控镇痛滴定芬太尼透皮贴剂的安全性与有效性[J].中国肿瘤临床,2016,43(5):194-198. [6] 冉凤鸣,臧爱华.芬太尼透皮贴剂治疗中重度癌性疼痛的临床观察[J].中国医院用药评价与分析,2009,9(8):625-626. [7] 钱羽,周亚娟,臧爱华. 芬太尼透皮贴癌痛治疗回顾[J]. 中国疼痛医学杂志2010,16(4):438-440. [8] 孙燕,顾慰萍.癌症三阶梯止痛指导原则[M].2版.北京:北京医科大学出版社,2002:15-17. [9] 赵春玲,张新,陈洪华,等.芬太尼透皮贴剂治疗晚期癌症患者疼痛的临床观察及护理[J].护理研究,2004,18(18):153. [10] 刘宁湘,钟伟元. 芬太尼透皮贴剂治疗328例晚期癌症重度疼痛[J].暨南大学学报(医学版),2010,31(4):421-422. [11] Tassinari D,Sartori S,Tamburini E,et al.Adverse effects of transdermal opiates treating moderate-severe cancer pain in comparison to long-acting morphine:a meta-analysis and systematic review of the literature[J].J Palliat Med,2008,11(3):492-501. [12] 茹鲜·吾斯曼,帕提古丽·阿尔西丁,王霞.等效剂量吗啡缓释片与芬太尼透皮贴剂治疗消化道癌痛的临床疗效[J].新疆医科大学学报,2010,33(9):1140-1144. [13] 戴永美,崔同建,林贵山,等. 大剂量芬太尼透皮贴剂治疗晚期癌痛的临床观察[J].现代肿瘤学,2016,24(3):466-467. [14] 陈路佳,唐榕,向帆,等. 芬太尼透皮贴剂或吗啡缓释片治疗中重度癌痛的系统评价[J].中国药业,2015,24(18):51-55. [15] 于晓丽,韩灵敏,韩春山. 芬太尼透皮贴剂治疗癌性腹胀患者的疗效观察[J]. 川北医学院学报,2015,30(6):790-793. -
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