鞘内药物输注系统植入术治疗难治性神经病理性疼痛初步疗效观察

Clinical observation of the effect of a totally implantable programmable device for continuous intrathecal infusion in the treatment of intractable neuropathic pain

目的观察鞘内药物输注系统植入术治疗难治性神经病理性疼痛的疗效,以及对患者生活质量的改善情况。方法采用鞘内药物输注系统植入术治疗3例典型神经病理性疼痛且药物治疗效果欠佳,或出现严重药物不良反应患者,共随访6~14个月,观察疼痛缓解率、睡眠改善程度、镇痛药物服用剂量及药物不良反应。结果治疗后3例患者视觉模拟评分均显著下降,由术前的中至重度疼痛改善至术后轻度疼痛,爆发痛次数减少;镇痛药物服用剂量约降至术前的10%;睡眠质量明显改善。随访期间均未发生手术相关性并发症和吗啡不良反应。结论鞘内药物输注系统对经鞘内吗啡试验镇痛效果满意的难治性神经病理性疼痛患者具有较为肯定的近期疗效。

Objective To observe the curative effect an d life quality improvement in patients with intractable neuropathic pain(NP) after implanting a programmable continuous intrathecal infusion pump.Metho dsThree cases of intractable neuropathic pain with poor me dicine efficacy or serious a dverse drug reactions ha d been followe d up for 6-14 months after being implante d programmable intrathecal infusion pump. Pain relief, sleep quality improvement, dosage of oral analgesics an d drug si de effect were observe d.ResultsAfter treatment the Visual Analogue Scale(VAS) of 3 patients decrease d significantly, with pain releasing from preoperative mo derate or severe pain to postoperative mil d pain an d decrease of fulminating pain frequency. Dosage of oral analgesics decline d to 10% of its preoperative dose an d sleep quality was improve d obviously. Neither postoperative complications nor si de effect of morphine was observe d during the follow up.ConclusionThe treatment of implanting a totally programmable continuous intrathecal infusion pump is eutherapeutic to the patients with intractable neuropathic pain who have achieve d satisfactory analgesic effect in experimental therapy.