镇痛泵持续静脉泵注吗啡控制难治性癌痛的临床观察

Clinical Observation of Continuous Intravenous Morphine Pumping in Patients with Refractory Cancer Pain

目的评价镇痛泵静脉持续泵注吗啡治疗难治性癌痛的疗效及可行性。方法对2010年4月—2011年8月在本院应用镇痛泵静脉持续泵注吗啡控制癌痛的84例患者进行观察,评估首次疼痛缓解时间、疼痛强度的变化、疼痛缓解率和不良反应,记录治疗前后的数字分级法(numerical rating scale,NRS)评分并作比较。结果首次疼痛缓解时间平均为32 min;应用镇痛泵前后NRS评分的均值分别为7.57分和1.87分(P<0.001);全组病例的疼痛缓解率为91.7%;不良反应主要为便秘、恶心呕吐和尿潴留。结论镇痛泵静脉持续泵注吗啡控制难治性癌痛,其首次疼痛缓解时间短、NRS评分明显下降、疼痛缓解率高、不良反应小,是一种有效、安全、简便易行的治疗难治性癌痛的方法。

Objective To investigate the efficacy and feasibility of continuous intravenous morphine pumping in patients with refractory cancer pain.Methods A total of 84 patients with refractory cancer pain underwent continuous intravenous morphine pumping from April 2010 to Aug,2011.And to evaluate the time of beginning pain relief,pain intensity,the degree of pain relief and its adverse reaction.And to compare the numerical rating scale（NRS） before and after treatment.Results The average time of beginning of pain relief was 32 min.The NRS before and after treatment were 7.57 and 1.87 respectively（P〈0.001）.The degree of pain relief was 91.7%.The main adverse reaction was constipation,nausea,vomiting and urine retention.Conclusion Continuous intravenous morphine pumping is effective,safe and feasible in the treatment of refractory cancer pain.