上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2013, Vol. 33 ›› Issue (6): 823-.doi: 10.3969/j.issn.1674-8115.2013.06.025

• 论著（临床研究） • 上一篇    下一篇

吗啡、甲强龙及氨茶碱治疗晚期肿瘤患者呼吸困难疗效比较

刘 峰，王美玲，袁海花，王 彦，姜 斌   

  1. 上海交通大学 医学院附属第三人民医院肿瘤科， 上海 201900
  • 出版日期:2013-06-28 发布日期:2013-06-28
  • 通讯作者: 王美玲, 电子信箱: 1228765526@qq.com。
  • 作者简介:刘峰（1974—）， 男， 主治医师， 博士; 电子信箱: nuanliu@126.com。
  • 基金资助:

    上海交通大学医工(理)交叉研究基金项目（YG2012MS28）

Effects of morphine, methylprednisolone and aminophylline on management of dyspnea in patients with advanced cancer

LIU Feng, WANG Mei-ling, YUAN Hai-hua, WANG Yan, JIANG Bin   

  1. Department of Oncology, the Third People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201900, China
  • Online:2013-06-28 Published:2013-06-28
  • Supported by:

    Foundation of Shanghai Jiaotong University, YG2012MS28

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摘要：

目的 比较吗啡、甲强龙（甲泼尼龙）和氨茶碱治疗晚期肿瘤患者呼吸困难的疗效。方法 170例晚期肿瘤呼吸困难者随机分三组，分别给予5~10 mg吗啡皮下注射（吗啡组，n=60）、40 mg甲强龙静脉点滴（甲强龙组，n=55）和025 g氨茶碱静脉点滴（氨茶碱组，n=55）治疗，通过视觉模拟评分（VAS）比较三种药物在治疗晚期肿瘤患者呼吸困难中的优劣。结果 治疗前三组患者间VAS评分比较差异无统计学意义（P>0.05）；但治疗后三组的VAS评分均显著低于治疗前，差异有统计学意义（P<0.01）。治疗后，吗啡组、甲强龙组和氨茶碱组的VAS评分分别为（12.82±11.40）、（24.58±17.51）和（34.25±17.75）mm，吗啡组显著低于甲强龙组和氨茶碱组，差异有统计学意义（P<0.01）；吗啡组控制呼吸困难有效率明显高于甲强龙组和氨茶碱组，差异有统计学意义（86.67%、67.27%和50.91%，P<0.05或P<0.01）。结论 吗啡用于治疗晚期肿瘤患者呼吸困难的疗效优于甲强龙和氨茶碱，能提高预计生存期较短的晚期肿瘤患者的生存质量。

关键词: 吗啡, 甲泼尼龙, 氨茶碱, 呼吸困难, 晚期肿瘤

Abstract:

Objective To investigate the effects of morphine, methylprednisolone and aminophylline on the management of dyspnea in patients with advanced cancer. Methods One hundred and seventy patients with advanced cancer suffering from dyspnea were randomly managed with morphine (5 to 10 mg, subcutaneous injection; morphine group, n=60), methylprednisolone (40 mg, intravenous administration; methylprednisolone group, n=55) and aminophylline (0.25 g, intravenous administration; aminophylline group, n=55), and the visual analogue scale (VAS) was adopted to evaluate the therapeutic effects. Results There was no significant difference in VAS among three groups before treatment (P>0.05). VAS after treatment was significantly lower than that before treatment in each group (P<0.01). VAS after treatment in morphine group, methylprednisolone group and aminophylline group were (12.82±11.40) mm, (24.58±17.51) mm and (34.25±17.75) mm respectively, and VAS in morphine group was significantly lower than those in methylprednisolone group and aminophylline group (P<0.01). The effective rate in control of dyspnea in morphine group (86.67%) was significantly higher than those in methylprednisolone group (67.27%) and aminophylline group (50.91%)(P<0.05 or P<0.01). Conclusion Morphine is more effective than methylprednisolone and aminophylline for dyspnea management in advanced cancer, and can improve the quality of life in patients with advanced cancer.

Key words: morphine, methylprednisolone, aminophylline, dyspnea, advanced cancer