在医疗能力有限的国家,哪种策略可以处理镰状细胞病患者的严重血管闭塞危机?

L. Ngolet, Chelsea Jayne Bango, Peggy Mawandza, A. Dokekias
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引用次数: 0

摘要

我们评估了静脉注射吗啡与间歇皮下注射吗啡对镰状细胞病患者并发严重血管闭合性危机的治疗效果。目的:主要目的是比较静脉自控镇痛(PCA)与间歇性皮下注射吗啡(SC)对入院前24小时出现严重血管闭塞危像的镰状细胞患者的治疗效果。次要目的是评估吗啡在两种治疗方案中的副作用。方法:在刚果共和国布拉柴维尔镰状细胞中心对77例PCA患者和81例SC患者进行了随机对照试验。参与者年龄在15至45岁之间,有严重的血管闭塞危像。结果:两种治疗方案均能缓解疼痛。然而,PCA组在吗啡给药30分钟后疼痛明显减轻(P= 0.001)。原始研究文章Ngolet et al.;中国生物医学工程学报,12(2):7-13,2021;文章no.IBRR。PCA和SC方案分别为:1.16±1.40和4.30±2.32。PCA组吗啡总中位剂量为24.6±4.16 mg,明显低于SC组36.6±3.1 mg (P=0.01)。PCA给药吗啡能在24小时内缓解疼痛,SC组出现间歇性剧烈疼痛(P=0.014)。SC组患者镇静评分S2、S3差异有统计学意义(P< 0.05)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Which Strategy to Manage Severe Vaso-occlusive Crisis in Patients with Sickle Cell Disease in Countries with Limited Healthcare Capacities?
We evaluated the treatment of morphine by intravenous patient controlled analgesia versus intermittent subcutaneous routes on patients with sickle cell disease developing severe vasoocclusivecrisis. Objectives: The primary objective was to compare intravenous patient controlled analgesia (PCA) versus intermittent subcutaneous injection of morphine (SC) on sickle cell patients developing severe vaso-occlusive crisis during the first 24 hours of admission. The secondary objective was to assess the side effects of morphine in both regimens. Methods: A randomized controlled trial of 77 patients in the PCA and 81 in the SC group was conducted at the Sickle Cell Center of Brazzaville in the Republic of Congo. Participants aged from 15 to 45 years old with severe vaso-occlusive crisis were included in the study. Results: Both regimens provided pain relief. However, a significant pain reduction was observed 30 minutes after the administration of morphine in the PCA group (P= 0.001). The mean scores in the Original Research Article Ngolet et al.; IBRR, 12(2): 7-13, 2021; Article no.IBRR.65227 8 PCA and SC regimens were respectively: 1.16±1.40 and 4.30±2.32. The total median dose of morphine administered in the PCA regimen was markedly lower: 24,6±4,16 mg versus 36.6±3.1 mg in the SC group (P=0.01). Morphine administered by PCA provided pain relief during 24 hours while intermittent severe pain was experienced in the SC group (P=0.014). Sedation score S2, S3 was significantly observed in the SC group (P< 0.05).
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