持续吗啡皮下泵注治疗老年中重度癌痛42例临床分析

Continuous subcutaneous morphine pumping for severe pain in senile late stage cancer-clinical analysis of 42 cases

目的探讨持续吗啡皮下泵注治疗老年癌性疼痛(癌痛)的止痛效果。方法共收治42例中重度癌痛患者,吗啡的初始剂量为30-60mg/d,予以微量控制泵24h持续皮下泵注,观察1-2d疼痛无缓解即进行个体剂量调整,按30%-50%剂量逐渐递增,直到疼痛缓解。结果42例中重度癌痛患者,显效35例(83.3%),有效6例(14.3%),无效1例(2.4%),总有效率97.6%。药物最小剂量为40mg/d,最大剂量为120mg/d,不良反应只须对症处理,大部分患者均可耐受,未见有药物依赖性出现。结论吗啡皮下泵注治疗癌痛,镇痛效果满意,不良反应较轻,适合于口服吗啡效果不佳的中重度癌痛患者。

Objective To evaluate the effect of treating the senile late stage cancer by continuous subcutaneous morphine pumping. Methods Forty-two patients with chronic ,moderate or severe cancer pain were studied. Morphine was infused subcutaneously via Volumetric Infusion Pump, and the daily initial dosage started from 30～60mg. If the pain was not relieved after 1～ 2 days＇ manipalation, the dosage was increased to 30%～50% each step. Results The complete response rate was 83.3% （35 cases）, effective rate 14.3%（6 cases）,no response rate 2.4%（1 cases） with an overall effective rate of 97.6%. It could be tolerated by most of the patients and the side effects could be cured by symptomatic treatment and no drug addiction was observed. Conclusions Continuous subcutaneous morphine pumping is a safe and effective method for relieving late stage cancer pain with mild side effects.