盐酸氢吗啡酮镇痛泵在难治性癌痛中的应用

目的 探究盐酸氢吗啡酮镇痛泵应用于难治性癌痛患者的镇痛效果。方法 选取2020年1月至2022年12月在浙江省肿瘤医院就诊的90例晚期难治性癌痛患者作为研究对象，使用随机数字表法分为观察组和对照组，每组各45例。两组患者均给予常规癌痛护理，对照组患者给予吗啡镇痛泵治疗，观察组患者给予盐酸氢吗啡酮镇痛泵治疗。比较两组患者的疼痛缓解情况、干预前后暴发痛发作次数、睡眠质量及抑郁情况、生活质量及自我效能感评分、药物不良反应发生情况。结果 观察组患者镇痛总有效率、服药依从性及护理满意度高于对照组（P<0.05）；干预后24h、72h、7d时，两组患者暴发痛发作次数低于干预前，且观察组低于对照组（P<0.05）；干预后24h、72h、7d时，两组患者的匹兹堡睡眠质量指数量表评分低于干预前，干预后7d时，观察组低于对照组（P<0.05）；两组患者的生活质量量表中的心理、躯体、生活、社会领域评分高于干预前，且观察组高于对照组（P<0.05）；两组总不良反应发生情况比较差异无统计学意义（P>0.05）。结论 盐酸氢吗啡酮镇痛泵应用于难治性癌痛患者具有良好的疼痛缓解效果，可降低患者暴发痛发作次数，改善患者的睡眠质量和抑郁情况，提高其生活质量和自我效能感评分且安全性较好。

Application of hydromorphone hydrochloride analgesic pump in refractory cancer pain

Objective To investigate the effect of hydromorphone hydrochloride analgesic pump in patients with refractory cancer pain. Methods A total of 90 patients with advanced refractory cancer pain treated in Zhejiang Cancer Hospital from January 2020 to December 2022 were selected as the study objects, and were divided into observation group and control group using random number table method, with 45 cases in each group. Both groups were given routine cancer pain care, patients in control group was given morphine analgesic pump treatment, patients in observation group was given hydromorphone hydrochloride analgesic pump treatment. The pain relief, the number of pain attacks, sleep quality and depression, quality of life and self-efficacy scores, and the occurrence of adverse drug reactions were compared between the two groups. Results The total effective rate of analgesia, medication compliance and nursing satisfaction in observation group was higher than that in control group (P<0.05). At 24h, 72h and 7d after intervention, the frequency of sudden pain was lower than before intervention, and the observation group was lower than the control group (P<0.05). At 24h, 72h and 7d after intervention, the scores of Pittsburgh sleep quality index in both groups were lower than before intervention, and at 7d after intervention, the observation group was lower than the control group (P<0.05). The scores of quality of life scale in psychological, physical, life and social fields were higher in two groups than before treatment, and observation group was higher than control group (P<0.05). There was no significant difference in the occurrence of total adverse reactions between the two groups (P>0.05). Conclusion The application of hydromorphone hydrochloride analgesic pump in patients with refractory cancer pain has a good pain relief effect, which can reduce the frequency of outburst pain, improve sleep quality and depression, improve quality of life and self-efficacy score, and the security is better.