全自动持续吗啡皮下泵注治疗重度癌痛的临床护理

Nursing research in continuous subcutaneous morphinepumping for severe cancer pain

目的探讨全自动持续吗啡皮下泵注治疗癌性疼痛的镇痛效果以及相关护理注意事项。方法共收治48例重度癌痛患者,吗啡的初始剂量为60 mg.d-1,予以微量控制泵24 h持续皮下泵注,观察一天疼痛无缓解即进行个体剂量调整,按30%剂量逐渐递增,直到疼痛缓解。结果48例重度癌痛患者,显效40例(83.3%),有效6例(12.5%),无效2例(4.2%),总有效率95.8%。药物最小剂量为60 mg.d-1,最大剂量为280 mg.d-1,不良反应只须对症处理,大部分患者均可耐受。结论吗啡皮下泵注治疗重度癌痛,镇痛效果满意,不良反应较轻,适合于常规口服吗啡无效的重度癌痛患者。

Aim To evaluate the effect of treating the severe cancer pain by continuous subcutaneous morphine and point for attention of nursing care. Methods Forty-eight patients with severe cancer pain were treated. Morphine was infused subcutaneously by volumetric infusion pump. Initial dosage started from 60 mg · d^ -1. If the pain was not relieved, the manipalation dosage was increased by 30% each time until painless. Results The complete response rate was 83.3% （40 cases）, effective rate 12.5% （6 cases） no response rate 4.2% （1 case） with an overall effective rate of 95.8%. It could be tolerated by most of the patients and the side effects could be cured by symptomatic treatment. Conclusion Continuous subcutaneous morphine pumping is a safe and effective method for severe cancer pain which in conventional oral morphine has no effect.