硬膜外埋入式输注系统外接持续输入泵用于晚期癌痛的临床研究

The Clinical Study of Embedded Epidural Infusion System Externally Connected with An Automatic Infusion Pump in Advanced Canner Pain

目的:探讨硬膜外埋入式输注系统外接持续输入泵(PCA)用于晚期癌痛的疗效、可行性及安全性。方法:46例中、重度晚期癌痛患者采用硬膜外埋入式输注系统外接PCA注药镇痛,PCA总容量为250 ml,设定维持量、单次冲击量、锁定时间等参数。记录患者术前1 d、术后3 h、3 d、15 d和30 d VAS评分及术前1 d、术后7 d、15 d、30 d疼痛对生活质量影响评分,并观察镇痛后恶心、呕吐、便秘、尿潴留的发生率。结果:治疗后46例患者VAS评分及疼痛对生活质量影响评分均明显降低(P<0.05),术后少数患者出现尿潴留、皮肤瘙痒、恶心呕吐,但与术前比较无明显差异(P>0.05)。结论:硬膜外埋入式输注系统外接PCA在晚期癌症镇痛中疗效确切,患者生活质量明显改善,不良反应少,值得临床推广。

Objective： To investigate the curative effect , feasibility and safety of embedded epidural infusion system externally connected with an automatic infusion pump （PCA） in advanced canner pain. Method： 46 patients with moderate or sever advanced cancer pain were continuously infused the drugs by an embedded epidural infusion system externally connected with PCA to relieve pain. The nominal volume of a PCA was 250 ml ,it was set continuous infusion doses,single doses and locking time parameters etc. Recorded of patients 1 day before operation,3 h after the operation,3 d,1 5 d and 30 d VAS score and 1d before operation,7 d after the operation, 15 d and 30 d the influence of pain on quality of life score,also observed the incidence of adverse reactions about nausea and vomiting, constipation,retention of urine. Results： Among the 46 cases,VAS score and the influence of pain on quality of life score were decreased significantly after treatment （P 〈 0.05）.A few cases after operation had retention of urine,skin itching,nausea and vomiting,butit were no statistically differences compared with preoperative （P 〉 0.05）. Conclusion： It is specifically effective for embedded epidural infusion systems externally connected with PCA in advanced cancer pain .It is worthy of clinical promotion because of significantly improving in quality of the life and less adverse reaction.