硬膜外腔注射乙醇对晚期癌症止痛作用的临床与实验研究

A clinical and experimental investigation on effect of ethanol on cancer pain

目的 通过观察硬膜外腔注射不同浓度乙醇对晚期癌痛患者的止痛效果和并发症以及对家兔神经组织损伤修复的作用,探讨安全有效的乙醇浓度及剂量。方法选用50％、75％及100％3种浓度的乙醇行硬膜外腔注射止痛及实验兔L2-3硬膜外腔注射,光镜、电镜观察对脊神经组织的影响。结果50％的乙醇止痛时间短,效果差,尚需补充止痛剂;100％的乙醇止痛效果确切,但不良反应严重;75％的乙醇止痛效果确切,并发症少。动物实验表明,三种不同浓度乙醇对神经损伤程度依次为100％>75％>50％。结论硬膜外腔注射75％的乙醇治疗对晚期癌痛疗效满意,副作用少。

Objective To explore the safe effective concentration and dosage of ethanol and to observe the analgesic effect and complication of ethanol in late cancer by injecting ethanol at various concentrations into the epidural space.Methods 50%,75% and 100% ethanol were injected into the opidural spaces of patients and rabbits,and its effect on nerve tissue was observed with light and electron microscope. Results The analgesic effect of 50% ethanol was indistinct and analgesic time was of very short duration; 100% ethanol was better but had serious adverse reaction;75% ethanol has less complications and was more appropriate. The animal experiment showed that the toxic effect of ethanol at various concentrations on nerve tissue was as follows: 100% > 75% > 50% . Conclusion The analgesic efficacy of 75% ethanol was satisfactory and is suitable for patients.