吗啡使用和急性胰腺炎的临床结果:第三级中心回顾性队列研究
Abdulrahman Ibn Awadh1, Renad Meshal Alharbi2, Mohannad Abuobaid3
1Department of Medicine, Case Western Reserve University/University Hospitals, Cleveland, OH, USA.
BMC gastroenterology
|December 30, 2025
概括
早期在急性胰腺炎 (AP) 中使用吗啡与临床恶化无关. 这项研究表明,阿片类止痛药对于AP疼痛管理是安全的,但需要进一步的研究.
科学领域:
- 胃肠病学 胃肠病学
- 临床药理学 临床药理学
背景情况:
- 由于潜在的并发症,在急性胰腺炎 (AP) 中使用吗啡的安全性受到争议.
- 这项研究调查了早期吗啡给药与AP患者的临床恶化之间的联系.
研究的目的:
- 评估早期吗啡使用是否与急性胰腺炎患者的临床恶化相关.
- 评估早期阿片类止痛药在AP的疼痛管理中的安全性.
主要方法:
- 对154名AP患者 (2012-2024) 的回顾性队列研究.
- 被吗啡分层的患者在入院后48小时内使用吗啡.
- 主要结局:综合临床恶化 (死亡率,通风,血管压缩剂,手术,长时间住院,CRP翻倍,器官衰竭).
- 多变量逻辑回归调整为混因子.
主要成果:
- 53名患者接受了早期吗啡治疗;临床恶化没有显著差异 (调整后OR=0.61,p=0.19).
- 接受吗啡的人的机械通风率较低 (17.0%与35.6%,p=0.02).
- 高剂量阿片类药物使用 (MME ≥100) 也没有与恶化相关 (调整后OR=0.92,p=0.87).
结论:
- 早期的吗啡和阿片类药物使用与该AP队列的临床恶化无关.
- 这些发现支持早期阿片类止痛药用于AP疼痛控制的安全性.
- 建议进行进一步的前性研究,以确认因果关系和指导建议.
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