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目的:观察肝癌选择性肝动脉栓塞化疗(Transarterial chemoembolization,TACE)术后口服氨酚羟考酮(泰勒宁)和盐酸曲马多(奇曼丁)进行治疗栓塞后综合征的有效性和安全性。方法:60例NRS评分>3分的肝癌TACE术后男性患者,随机分两组,分别口服泰勒宁和奇曼丁。观察并记录术后即刻、术后0.5,0,1,2,6,12,24,48,72 h的NRS评分、疼痛强度与缓解度变化、EORTC QLQ-C30评分以及不良反应。结果:氨酚羟考酮组、曲马多组均能在术后1 h达到较为满意止痛效果,但氨酚羟考酮组起效时间较曲马多组为短,在术后0.5 h可达到满意效果。与治疗前比较,两组生活质量均有提高。曲马多组发热高于氨酚羟考酮组,两组恶心、呕吐、头晕发生率相仿,但氨酚羟考酮组的消化道反应及嗜睡较曲马多组为多。结论:氨酚羟考酮较曲马多更适于肝癌TACE栓塞后综合征的对症治疗,值得临床推广使用。
OBJECTIVE: To observe the efficacy and safety of oral administration of paracetamol and thalidomide after transarterial chemoembolization (TACE) for the treatment of post-embolization syndrome . Methods: Sixty male patients with hepatocellular carcinoma after TACE with NRS score> 3 were randomly divided into two groups and were treated with Tylerin and Chimandrin. The scores of NRS, pain intensity and remission, EORTC QLQ-C30 score and adverse reactions were observed and recorded immediately after operation, 0.5,0,1,2,6,12,24,48,72 h after operation. Results: The paracetamol and tramadol groups all achieved satisfactory analgesic effect at 1 h after operation, but the onset time of paracetamol and oxycodone group was shorter than that of tramadol group and 0.5 h after operation Achieve satisfactory results. Compared with before treatment, both groups have improved the quality of life. The fever in tramadol group was higher than that in oxycodone group. The incidences of nausea, vomiting and dizziness were similar in both groups. However, the gastrointestinal reactions and lethargy were more in the tramadol group than in the tramadol group. Conclusion: Oxycodone is more suitable for symptomatic treatment of post-TACE syndrome of liver cancer than tramadol, which is worthy of clinical promotion.