2025 年第 5 期 第 20 卷

羟考酮在CT引导下微弹簧圈穿刺定位肺结节术中的应用效果和量效关系研究

Study on the application effect and dose-effect relationship of oxycodone in CT-guided micro-coil puncture localization of pulmonary nodules

作者：金如意1刘晓宇2张民皓3谭婧3顾连兵3王丽君1,3

英文作者：Jin Ruyi1 Liu Xiaoyu2 Zhang Minhao3 Tan Jing3 Gu Lianbing3 Wang Lijun13

单位：1徐州医科大学江苏省麻醉学重点实验室，徐州221004；2南京医科大学附属逸夫医院麻醉科，南京211100；3江苏省肿瘤医院江苏省肿瘤防治研究所南京医科大学附属肿瘤医院麻醉科，南京210009

英文单位：1Jiangsu Province Key Laboratory of Anesthesiology Xuzhou Medical University Xuzhou 221004 China; 2Department of Anesthesiology Sir Run Run Hospital Nanjing Medical University Nanjing 211100 China; 3Department of Anesthesiology Jiangsu Cancer Hospital Jiangsu Institute of Cancer Research the Affiliated Cancer Hospital of Nanjing Medical University Nanjing 210009 China

关键词：CT引导下微弹簧圈穿刺定位肺结节术；羟考酮；局部麻醉；视觉模拟量表评分；量效关系

英文关键词：CT-guidedmicro-coilpuncturelocalizationofpulmonarynodules;Oxycodone;Localanesthesia;Visualanaloguescalescore;Dose-effectrelationship

• 摘要：

• 目的 探讨羟考酮在CT引导下微弹簧圈穿刺定位肺结节术中的应用效果和量效关系。方法 选取2023年12月至2024年6月于江苏省肿瘤医院接受CT引导下微弹簧圈穿刺定位肺结节术的125例患者。采用随机数字表法将患者分为对照组及羟考酮1、2、3、4组，各25例。对照组手术开始前静脉推注与其他组等容量的0.9%氯化钠溶液；羟考酮1、2、3、4组手术开始前分别静脉推注1 mg/ml的盐酸羟考酮注射液0.025、0.05、0.075、0.1 mg/kg。比较5组患者围穿刺期疼痛视觉模拟量表（VAS）评分，围穿刺期中重度疼痛发生率，入室时、穿刺前、穿刺时、穿刺结束时的基本生命体征，穿刺中刺激性症状发生率，一次穿刺成功率以及药物不良反应发生率。结果 本研究中羟考酮2组和羟考酮4组分别有1例患者被剔除。对照组及羟考酮1、2、3、4组VAS评分分别为（4.7±1.6）、（3.9±1.5）、（2.9±1.7）、（1.6±1.4）、（1.4±1.1）分，中重度疼痛发生率分别为64.0%（16/25）、56.0%（14/25）、37.5%（9/24）、8.0%（2/25）、4.2%（1/24）。羟考酮3组及羟考酮4组VAS评分均显著低于对照组、羟考酮1组和羟考酮2组（均P＜0.05）。羟考酮3组中重度疼痛发生率显著低于对照组和羟考酮1组（均P＜0.05）。穿刺时，羟考酮3组和羟考酮4组心率均显著低于对照组和羟考酮1组（均P＜0.05）。羟考酮3组、羟考酮4组呼吸不配合及体动发生率均显著低于对照组（均P＜0.05）；羟考酮4组头晕及恶心呕吐发生率均显著高于其余4组（均P＜0.05）。结论 在CT引导下微弹簧圈穿刺定位肺结节术中静脉注射0.075 mg/kg及0.1 mg/kg羟考酮均可有效减轻患者的疼痛，降低穿刺过程中的中重度疼痛发生率，显著提高患者配合度，其中0.075 mg/kg羟考酮药物不良反应较少。

• Objective To investigate the application effect and dose-effect relationship of oxycodone in CT-guided micro-coil puncture localization of pulmonary nodules. Methods A total of 125 patients who underwent CT-guided micro-coil puncture localization of pulmonary nodules in Jiangsu Cancer Hospital from December 2023 to June 2024 were selected.The patients were divided into control group and oxycodone 1, 2, 3 and 4 groups by random number table method, with 25 cases in each group. In the control group, the same volume of 0.9% sodium chloride solution was injected intravenously before the operation, and 1 mg/ml oxycodone hydrochloride injection 0.025 mg/kg, 0.05 mg/kg, 0.075 mg/kg, and 0.1 mg/kg were injected intravenously in oxycodone 1, 2, 3, and 4 groups before operation, respectively. The visual analogue scale (VAS) score during the peri-puncture period, the incidence of moderate and severe pain during the peri-puncture period, the basic vital signs at admission, before puncture, during puncture and at the end of puncture, the incidence of irritating symptoms during puncture, the success rate of one-time puncture and the incidence of adverse drug reactions were compared among the five groups. Results One patient in the oxycodone 2 group and one in the oxycodone 4 group were excluded from the study. The VAS scores of the control group and oxycodone 1, 2, 3, 4 groups were (4.7±1.6), (3.9±1.5), (2.9±1.7), (1.6±1.4), and (1.4±1.1), respectively. The incidences of moderate and severe pain were 64.0%(16/25), 56.0%(14/25), 37.5%(9/24), 8.0%(2/25), and 4.2%(1/24), respectively.The VAS scores of oxycodone 3 group and oxycodone 4 group were significantly lower than those of control group, oxycodone 1 group and oxycodone 2 group(all P<0.05). The incidence of moderate to severe pain in oxycodone 3 group was significantly lower than that in control group and oxycodone 1 group (both P<0.05). At the time of puncture, the heart rates of the oxycodone 3 groupand oxycodone 4 group were significantly lower than those of the control group and oxycodone 1 group(all P<0.05). The incidences of respiratory incompliance and body movement in oxycodone 3 group and oxycodone 4 group were significantly lower than those in control group (all P<0.05). The incidences of dizziness, nausea and vomiting in oxycodone 4 group were significantly higher than those in the other four groups(all P<0.05). Conclusion Intravenous injection of 0.075 mg/kg and 0.1 mg/kg oxycodone during CT-guided micro-coil puncture positioning of pulmonary nodules can effectively reduce the pain of patients, reduce the incidence of moderate and severe pain during puncture, and significantly improve the cooperation of patients, among which 0.075 mg/kg oxycodone has fewer adverse drug reactions.