[1]王 梓,穆可涛,吕银章,等.盐酸氢吗啡酮与地佐辛在经肝动脉化疗栓塞术镇痛中的作用[J].介入放射学杂志,2022,31(10):970-974.
 WANG Zi,MU Ketao,LV Yinzhang,et al.Analgesia effect of hydromorphone hydrochloride and dezocine in receiving transhepatic arterial chemoembolization: a comparative study[J].journal interventional radiology,2022,31(10):970-974.
点击复制

盐酸氢吗啡酮与地佐辛在经肝动脉化疗栓塞术镇痛中的作用()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
31
期数:
2022年10
页码:
970-974
栏目:
肿瘤介入
出版日期:
2022-11-07

文章信息/Info

Title:
Analgesia effect of hydromorphone hydrochloride and dezocine in receiving transhepatic arterial chemoembolization: a comparative study
作者:
王 梓 穆可涛 吕银章 赵凌云 李拔森 郝永红 徐安辉 王 南
Author(s):
WANG Zi MU Ketao LV Yinzhang ZHAO Lingyun LI Basen HAO Yonghong XU Anhui WANG Nan.
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430000, China.
关键词:
【关键词】 氢吗啡酮 肝癌 经肝动脉化疗栓塞术 不良反应
文献标志码:
A
摘要:
【摘要】 目的 探讨盐酸氢吗啡酮与地佐辛在经肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)中的镇痛效果及其不良反应。方法 纳入2021年1月至10月在华中科技大学同济医学院附属同济医院接受TACE的患者270例,将患者分为3组,每组90例。H1组:术前15 min静脉注射1 mg盐酸氢吗啡酮;H2组:术前15 min静脉注射2 mg盐酸氢吗啡酮,注射时间为2~3 min;D组:术前30 min肌内注射5 mg地佐辛。在手术开始时、药物注入后5 min和0.5、1、2、4、8、12 h对患者进行视觉模拟评分(visual analogue scale,VAS)。比较3组患者的VAS评分以及镇痛药物不良反应的发生情况。结果 3组患者不良反应比较,H1和H2组患者发生头晕、恶心、呕吐等不良反应的比例均小于D组(P<0.05);H2组有2例患者发生了呼吸抑制,另两组均未出现。3组患者应用镇痛药物各时间点VAS评分比较,H1和H2组术后0.5 h、1 h的VAS评分低于D组(P<0.05)。各组不同化疗药物比较,H1和H2组术后0.5 h、1 h的VAS评分低于D组(P<0.05)。各组不同栓塞药物比较,使用载药微球颗粒的H1、H2和D组患者的VAS评分差异无统计学意义(P>0.05),使用超液化碘油及明胶海绵颗粒的H1和H2组患者术后0.5 h、1 h的VAS评分低于D组(P<0.05)。各组不同CNLC分期分组比较,CNLC Ⅰ期H1、H2和D组患者的VAS评分差异无统计学意义(P>0.05), CNLC Ⅱ期及Ⅲ期H1组和H2组患者术后0.5 h、1 h的VAS评分低于D组(P<0.05)。结论 盐酸氢吗啡酮能够在有效镇痛的基础上减少阿片类药物引起的不良反应。

参考文献/References:

[1] Chen Z, Xie H, Hu M, et al. Recent progress in treatment of hepatocelular carcinoma[J]. Am J Cancer Res, 2020, 10:2993-3036.
[2] 张 雯,周永杰,颜志平. 再论精细TACE[J]. 介入放射学杂志, 2021, 30:971-975.
[3] Tsurusai M, Murakami T. Surgical and locoregional therapy of HCC:TACE[J]. Liver Cancer, 2015, 4:165-175.
[4] 罗 君,邵国良,郑家平,等. 原发性肝癌肝动脉化疗栓塞术后腹痛的发生规律及影响因素 [J]. 介入放射学志, 2017, 26:613- 617.
[5] Kang YJ,Lee BC,Kim JK,et al. Conventional versus small doxorubicin-eluting bead transcatheter arterial chemoembolization for treating barcelona clinic liver cancer stage 0/A hepatocellular carcinoma[J]. Cardiovasc Intervent Radiol, 2020, 43:55-64.
[6] Pomoni M, Malagari K,Moschouris H,et al. Post embolization syndrome in doxorubicin eluting chemoembolization with DC bead[J]. Hepatogastroenterology, 2012, 59:820-825.
[7] Lee SH, Hahn ST, Park SH. Intraarterial lidocaine administration for relief of pain resulting from transarterial chemoembolization of hepatocellular carcinoma: its effectiveness and optimal timing of administration[J]. Cardiovasc Intervent Radiol, 2002, 24:368-371.
[8] Razi M, Jianping G, Xu H. Conventional versus drug-eluting bead transarterial chemoembolization: a better option for treatment of unresectable hepatocellular carcinoma[J]. J Interv Med, 2020, 4:11-14.
[9] Mazer-Amirshahi M, Motov S, Nelson LS. Hydromorphone use for acute pain: misconceptions, controversies, and risks[J]. J Opioid Manag, 2018, 14:61-71.
[10] Okusaka T, Kasugai H, Shioyama Y, et al. Transarterial chemothrapy alone versus transarterial chemoembolization for hepatocellular carcinoma: a randomized phase Ⅲ trial[J]. J Hepatol, 2009, 51:1030-1036.
[11] Chinn E, Friedman BW,Naeem F,et al. Randomized trial of intravenous lidocaine versus hydromorphone for acute abdominal pain in the emergency department[J]. Ann Emerg Med, 2019, 74:233-240.
[12] Barnaby DP, Chertoff AE,Restivo AJ,et al. Randomized controlled trial of intravenous acetaminophen versus intravenous hydromor-phone for the treatment of acute pain in the emergency department[J]. Ann Emerg Med, 2019, 73:133-140.
[13] 王宏伟,李兰兰,李治松,等. 盐酸氢吗啡酮联合右美托咪定对经皮肝动脉化疗栓塞术治疗患者的静脉自控镇痛效果[J]. 中华肿瘤杂志, 2018, 40:253-3766.
[14] Shi H, Chen X, Liu X,et al. National drug utilization trend of analgesics in China: an analysis of procurement data at 793 public hospitals from 2013 to 2018[J]. J Pharm Policy Pract, 2021, 14:45
[15] Guo JG, Zhao LP, Rao YF, et al. Novel multimodal analgesia regimen improves post-TACE pain in patients with hepatocellular carcinoma[J]. HBPD INT, 2018, 17:510-516.
[16] Ding Y, White PF. Comparative efects of ketorolac, dezocine, and fentanyl as adjuvants during outpatient anesthesia[J]. Anesth Analg, 1992, 1:566–571.
[17] Li Y, Ma J, Lu G, et al. Hydromorphone for cancer pain[J]. Cochrane Database Syst Rev, 2021, 8:CD011108.

相似文献/References:

[1]王建新,许成平,邵亚男,等. 125Ⅰ-LUF体毛导向治疗晚期肝癌初步报告[J].介入放射学杂志,1997,(01):16.
[2]龚承友,初曙光,陈陵际,等.蓖麻蛋白对裸鼠肝癌瘤体内注射的疗效及骨髓抑制的研究[J].介入放射学杂志,1997,(04):219.
[3]马广勤,高从敬,万向荣,等.晚期肝癌变异性、寄生性供血的基础研究[J].介入放射学杂志,1998,(02):95.
[4]刘传方,詹迎江.外生型肝癌三例[J].介入放射学杂志,1998,(03):190.
[5]程红岩,曲增强,徐爱民,等.肝癌介入治疗中预防副反应的初步探讨[J].介入放射学杂志,1998,(03):161.
[6]黄小明,于淼,暴军玲,等.甲氧氯普胺治疗肝癌介入治疗中的胃肠道反应[J].介入放射学杂志,1998,(04):245.
[7]张桂敏,陆翠玉.肝癌介入治疗术后物品的消毒处理[J].介入放射学杂志,1998,(04):244.
[8]杨熙章,吴纪瑞,杨永岩,等.灌注化疗预防肝癌术后复发[J].介入放射学杂志,1999,(02):32.
[9]钟力,夏海平,王吉先,等.肝动脉栓塞化疗结合超声导向注射酒精治疗肝癌的疗效观察[J].介入放射学杂志,1992,(01):48.
[10]李章钧.晚期肝梅毒误为肝癌一例[J].介入放射学杂志,1993,(01):4.

备注/Memo

备注/Memo:
(收稿日期:2022-01-11)
(本文编辑:新 宇)
更新日期/Last Update: 2022-11-02