微量泵皮下自控镇痛治疗晚期癌痛30例疗效观察(1)
 |
| 第1页 |
参见附件(1722KB，2页)。
[摘要] 目的：探讨应用微量泵皮下自控镇痛治疗晚期癌痛临床效果。方法：选择60例晚期癌症患者，按入院顺序随机分为两组，每组各30例。Ⅰ组采用传统的肌内注射吗啡0.1~0.2 mg/kg镇痛，Ⅱ组采用微量泵自控皮下注入吗啡40 mg+2%利多卡因20 ml+氟哌利多2.5 mg+0.9%氯化钠至100 ml镇痛。采用视觉模拟评分法(VAS)评价两组镇痛效果，比较两组患者的48 h吗啡用量，调查患者对镇痛方法的满意度。结果：治疗后第1、2、3、7、10天，Ⅱ组患者的VAS评分显著低于Ⅰ组，差异有统计学意义(P<0.05)；患者满意度调查，Ⅰ组满意率为70.0%，Ⅱ组满意率达96.7%，差异有高度统计学意义(P<0.01)；48 h吗啡用量，Ⅰ组为(89.65±12.46)mg，Ⅱ组为(56.27±9.73)mg，两组比较差异有高度统计学意义(P<0.01)。结论：皮下自控镇痛用于晚期癌性疼痛镇痛效果好，吗啡用量显著减少，降低了药物毒副作用，患者满意度显著提高。
[关键词] 皮下自控镇痛；微量泵；晚期癌痛；患者满意度；视觉模拟评分法
[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210(2011)11(c)-086-02
Effect of 30 cases treated by percutaneous self-controlled analgesia technique on advanced cancer pain
TIAN Hua, XIANG Dengguo
Department of Anesthesia, the Central Hospital of Enshi Tujia-Miao Autonomous Prefecture, Hubei Province, Enshi 445000, China
[Abstract] Objective: To investigate the effect of pereutaneous seff-controfled analgesia technique on advanced cancer pain. Methods: 60 cases of advanced cancer treated in our hospital were divided randomly into groupⅠand groupⅡ. The patients of groupⅠwere received the injection of morphine for 0.1-0.2 mg/kg, while the group Ⅱ were treated by PCSA (morphine 40 mg+2% lidocaine 20 ml+droperidol 2.5 mg+0.9% natrium muriaticum to 100 ml). The visual analogue scales (VAS) was used to assess the analgesic effect of the two groups, the 48 h dosage of morphine and the patient satisfaction for analgesia method were analyzed. Results: The VAS score and the 48h dosage of morphine of groupⅠwere all significantly lower than group Ⅱ (P<0.01). The patient satisfaction of group Ⅱ (96.7%) was significantly better than group Ⅰ(70.0%) (P<0.05). Conclusion: Percutaneous self-controlled analgesia technique has a better analgesic effect on advanced cancer pain, with a higher patient satisfaction and less dosage of morphine.
[Key words] PCSA; Micro Pump; Advanced Cancer Pain; Satisfaction; VAS
疼痛是晚期癌症患者最主要的症状，给患者带来肉体和精神的折磨，严重降低了癌症晚期患者的生活质量。通过正规三阶梯镇痛可使60%~80%的癌痛缓解，但仍有10%~20%的顽固性疼痛无法缓解[1-3]。1982年WHO就提出“2000年实现全世界无癌痛”的目标，但迄今为止该目标仍远未达到。因此，如何解决顽固性中、重度癌痛已成为医学界的一大难题。近几年，有报道晚期癌痛自控镇痛(PCA)治疗，即将由患者或家属根据患者疼痛情况自控注药，获得满意疗效[1]。我院对于晚期癌痛患者采用皮下自控泵镇痛(PCSA)获得了满意的疗效，现报道如下：
1 资料与方法
1.1 一般资料
选取2007年10月~2011年2月在我院住院的晚期癌症患者60例。其中，男36例，女24例；平均年龄(54.0±6.9)岁；肝癌12例，肺癌9例，胃癌7例，食管癌3例，直肠癌术后复发8例，胰腺癌4例，乳腺癌2例 ......
您现在查看是摘要介绍页，详见PDF附件(1722KB，2页)。