摘要
目的评价硬膜外自控镇痛(PECA)对晚期癌痛的临床疗效,特别是剧烈的顽固性疼痛。方法观察了14例疼痛较剧烈的患者,其虽经不同途径(口服、皮下及静脉)使用大剂量阿片类药物,但未能很好地控制疼痛,同时毒副作用较大。对此采用PECA方法用于以上患者的镇痛,在减少阿片类药物用量的同时使镇痛效果明显提高。注射液浓度依病变部位及疼痛程度而定。一般为0.75%布比卡因40ml药液中加入吗啡10mg～20mg、氟哌啶5～10mg。同时,应严格锁定每次注液量及间隔时间。治疗效果由患者采用0～10疼痛自测分级表自行划定。结果癌痛完全缓解11例(78.57%),部分缓解3例(21.43%),缓解率为(100.0%)。治疗前后疼痛程度差异有显著性(P<0.01),患者治疗后生活质量较治疗前明显改善(P<0.05),毒副作用明显减轻。结论PECA治疗晚期顽固性癌痛疗效确切,方便、安全,且能增强镇静和抗焦虑作用,改善癌症患者的生活质量。
Objective To evaluate the effectiveness of patient - controlled epidural analgesia （ PECA ） for cancer pains in patients with advanced cancer. Methods The severe pains of fourteen patients with advanced cancer unresponsive to large doses of opiuro were treated with PECA. Morphine 10 -20mg and haloperidol 5 - 10mg were added into 0.75 % bupivacaine gOml and the doses and interval used were strictly controlled. Responses were assessed by use of the 0 - 10 Numeric Pain Intensity Scalel. Results Cancer pains were relieved completely in 11 patients （78.57 % ）, alleviated in 3 patients （21.43%）, therefore the response rate was 100.0 %. There were significant differences in the severities of pains before and after the treatment （ P〈0. 01 ）. The qualities of life （QL） of the patients were significantly improved（ P 〈0.05）. The toxic and side effects of the analgesics were reduced roarkedly. Conclusion PECA is a reliable, convenient and safe method for refractory cancer pains. Besides, PECA can enhance sedative and anti - anxiety effects and improve the QL of cancer patients.
出处
《临床和实验医学杂志》
2007年第2期11-12,共2页
Journal of Clinical and Experimental Medicine
基金
2004年马鞍山市科技局立项项目
关键词
癌痛
布比卡因
氟哌啶
盐酸吗啡
自控镇痛
Cancer pains
Bupivacaine
haloperidol
Morphine
Patient - controlled epidural analgesia
