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目的观察芬太尼合剂用于晚期癌痛家庭治疗的可行性。方法具有病理诊断的晚期癌痛患者300例,按传统法镇痛效果不佳就诊后根据其自愿原则分为4组:A组芬太尼经硬膜外间隙患者自控镇痛(PCEA,n=94);B组芬太尼经静脉患者自控镇痛(PCIA,n=77);C组为芬太尼常规输液镇痛(n=69例);D组对照组(n=60例)。由其法定代理人应用VAS标准评价总体镇痛效果和生活质量评分,并对比分析患者生存时间和主要并发症。结果统计数据显示总体VAS评分以D组最高,且组间两两对比差异有统计学意义(P<0.01);生活质量评分及生存时间均以C组为低,且组间两两对比差异也具有统计学意义(P<0.01)。主要并发症C组高于A、B组,但低于D组,其差异均有统计学意义(P<0.01)。结论芬太尼合剂通过PCEA、PCIA或常规静脉输液途径均可应用于晚期癌痛患者的家庭治疗,其中PCEA效果更显著。
Objective To observe the feasibility of fentanyl mixture for family therapy of advanced cancer pain. Methods Three hundred patients with advanced cancer pain diagnosed by pathology were divided into 4 groups according to their voluntary principles according to the traditional method of poor analgesic effect: group A was given epidural analgesia (PCEA, n = 94). Patients in group B received controlled intravenous analgesia (PCIA, n = 77). Patients in group C received routine infusion of fentanyl (n = 69) and patients in group D (n = 60). The VAS standard was used by its legal representative to evaluate the overall analgesic effect and quality of life score, and to compare and analyze the patient’s survival time and major complication. Results The statistical data showed that the overall VAS score was the highest in group D, and the pairwise comparisons between groups were statistically significant (P <0.01). The quality of life scores and survival time were lower in group C than in group C With statistical significance (P <0.01). The main complication was higher in group C than in group A, B, but lower than that in group D, the difference was statistically significant (P <0.01). Conclusion Fentanyl mixture can be applied to family therapy of patients with advanced cancer pain through PCEA, PCIA or routine intravenous infusion route. PCEA is more effective.