微量泵皮下自控镇痛治疗晚期癌痛30例疗效观察

Effect of 30 cases treated by percutaneous self-controlled analgesia technique on advanced cancer pain

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。

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（P0.01）.The patient satisfaction of group Ⅱ（96.7%） was significantly better than group Ⅰ（70.0%）（P0.05）.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.