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氢吗啡酮与吗啡对晚期恶性肿瘤患者呼吸困难的临床疗效比较

Clinical effect of hydromorphone versus morphine in treatment of dyspnea in patients with advanced malignant tumors

    摘要
  • 摘要:
    目的 比较氢吗啡酮与吗啡对晚期恶性肿瘤患者呼吸困难的临床疗效。
    方法 回顾性选取75例存在呼吸困难的晚期恶性肿瘤患者作为研究对象, 根据不同呼吸困难治疗方案分为A组、B组和C组, 每组25例。A组应用盐酸氢吗啡酮注射液皮下注射联合多索茶碱静脉滴注, B组应用吗啡注射液皮下注射联合多索茶碱静脉滴注, C组单纯应用多索茶碱静脉滴注。观察3组患者治疗前和治疗30、60 min时的呼吸困难程度采用视觉模拟评分法(VAS)评估、呼吸频率(RR)、心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO2), 并比较3组患者不良反应发生情况。
    结果 治疗前, 3组呼吸困难程度(VAS评分)、RR、HR、MAP、SpO2比较, 差异均无统计学意义(P>0.05); 3组治疗30、60 min时的VAS评分、RR均低于治疗前, 且治疗60 min时的VAS评分、RR均低于治疗30 min时, 差异有统计学意义(P < 0.05); 治疗30、60 min时, A组、B组VAS评分、RR均低于C组, 且A组VAS评分、RR均低于B组, 差异有统计学意义(P < 0.05); 治疗30、60 min时, 3组HR、MAP、SpO2比较, 差异均无统计学意义(P>0.05)。3组患者不良反应差异无统计学意义(P>0.05), 且均未发生严重不良反应。
    结论 与单独应用多索茶碱方案和吗啡联合应用多索茶碱方案相比, 氢吗啡酮联合多索茶碱方案能够更加有效且快速地缓解晚期恶性肿瘤患者的呼吸困难, 且不良反应可耐受。

     

    Abstract:
    Objective To compare the clinical efficacy of hydromorphone and morphine in the treatment of dyspnea in patients with advanced malignant tumors.
    Methods A total of 75 dyspnea patients with advanced malignant tumors were selected as study objects. According to the treatment therapies for dyspnea, they were divided into three groups. Group A (n=25) received subcutaneous injection of hydromorphone hydrochloride combined with intravenous infusion of doxofylline, group B (n=25) received subcutaneous injection of morphine injection combined with intravenous infusion of doxofylline, while group C (n=25)was treated with intravenous infusion of doxofylline alone. Visual Analog Scale (VAS) was used to compare the dyspnea of three groups after 30 and 60 min of medication. Respiratory rate (RR), heart rate (HR), mean arterial pressure (MAP) and blood oxygen saturation (SpO2) were compared, and the occurrence of adverse reactions among the three groups were compared.
    Results Before treatment, there were no significant differences in dyspnea degree (VAS score), RR, HR, MAP and SpO2 among three groups (P>0.05). VAS score and RR at 30 min and 60 min of treatment were lower than before treatment, and VAS score and RR at 60 min of treatment were lower than 30 min of treatment (P < 0.05). VAS score and RR in the group A and group B were lower than those in group C, and VAS score and RR in the group A were lower than those in group B (P < 0.05). After 30 and 60 min of treatment, there were no significant differences in HR, MAP and SpO2 among three groups (P>0.05). There was no significant difference in adverse reactions among the three groups (P>0.05), and no serious adverse reactions occurred.
    Conclusion Compared with doxofylline regimen alone and morphine combined with doxofylline regimen, hydromorphone combined with doxofylline regimen is more effective and rapid in alleviating dyspnea in patients with advanced malignant tumors, and the adverse reactions are tolerable.

     

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