摘要
目的探究吗啡泵鞘内植入术对顽固性癌痛患者镇痛效果和T淋巴细胞亚群水平的影响。方法选取2018年1月至2019年12月梅州市人民医院收治的顽固性癌痛患者60例,采用数字表法随机分为观察组和对照组,各30例。观察组患者采用吗啡泵鞘内植入术进行治疗;对照组患者给予口服盐酸羟考酮缓释片治疗,两组患者治疗周期均为2周。比较两组患者治疗期间疼痛爆发次数和治疗后临床疗效;对比治疗前后两组患者VAS评分、T淋巴细胞亚群水平、生活质量评分及睡眠质量评分。结果治疗后观察组患者临床总有效率为96.67%,显著高于对照组的73.33%(P<0.05);与治疗前比,治疗后两组患者VAS评分均显著降低,观察组显著低于对照组(P<0.05);与对照组比,观察组患者疼痛爆发次数显著减少(P<0.05);与治疗前比,治疗后两组患者CD4^+/CD8^+比值及观察组患者CD3^+、CD4^+百分比均显著升高,观察组显著高于对照组;与治疗前和对照组治疗后比,观察组患者CD8^+百分比显著降低(P<0.05);与治疗前比,治疗后两组患者生活质量评分和睡眠质量评分均显著降低,观察组显著低于对照组(P<0.05)。结论吗啡泵鞘内植入术作用于顽固性癌痛患者,可有效调节其机体T淋巴细胞亚群水平,增强免疫功能,缓解患者疼痛症状,减少疼痛爆发次数,改善患者生活质量和睡眠质量。
Objective To explore the effect of intrathecal implantation of morphine pump on the analgesic effect and T lymphocyte subsets level in patients with intractable cancer pain. Methods A total of 60 patients with intractable cancer pain admitted to Meizhou People’s Hospital from January 2018 to December 2019 were selected and divided into the observation group and the control group, according to random number table, 30 cases in each group. Patients in the observation group were treated with morphine pump intrathecal implantation, and patients in the control group were treated with oral oxycodone hydrochloride sustained-release tablets. The treatment period of both groups was 2 weeks.The number of pain outbreaks during treatment and the clinical efficacy after treatment were compared between the two groups of patients;VAS scores, T lymphocyte subsets levels, quality of life scores and sleep quality scores were compared between the two groups before and after treatment. Results After treatment, the clinical total effective rate in the observation group was 96.67%, which was significantly higher than 73.33% in the control group(P<0.05);Compared with before treatment, the VAS scores of the two groups of patients significantly reduced after treatment, and the observation significantly lower than that of the control group(P<0.05);Compared with the control group, the number of pain bursts in the observation group significantly reduced(P<0.05);Compared with before treatment, after treatment, the CD4^+/CD8^+ ratio of the two groups of patients and the percentage of CD3^+ and CD4^+ in the observation group significantly increased, and the observation group was significantly higher than the control group;Compared with before and after the treatment, the CD8^+ percentage of the observation group significantly reduced(P<0.05);Compared with before treatment, the quality of life scores and sleep quality scores of the two groups of patients significantly decreased after treatment, and the observation group was significantly lower than the control group(P<0.05). Conclusion Intrathecal implantation of morphine pump is effective for patients with intractable cancer pain, which can effectively regulate the level of T lymphocyte subsets, enhance immune function, relieve pain symptoms of patients, reduce the number of pain outbreaks, and improve the quality of life and sleep of patients.
作者
赖尚导
潘美苑
刘炯峰
陈伟元
曾志文
LAI Shangdao;PAN Meiyuan;LIU Jiongfeng;CHEN Weiyuan;ZENG Zhiwen(Department of Anesthesiology,Meizhou People's Hospital,Guangdong Meizhou 514031,China)
基金
梅州市科技计划项目(编号:181217092050234)。
关键词
吗啡泵鞘内植入术
顽固性癌痛
镇痛
T淋巴细胞亚群
睡眠质量
生活质量
Morphine pump intrathecal implantation
Refractory cancer pain
Analgesic effect
T lymphocyte subsets
Quality of life
Quality of sleep
