大剂量吗啡静脉自控镇痛治疗癌痛的不良反应与处理探讨

目的 探讨大剂量吗啡静脉自控镇痛用于治疗癌痛的不良反应与处理措施.方法 选取佛山市顺德区伦教医院于2009年1月至2012年1月间的癌症合并中重度疼痛、经口服或肌内注射阿片类等药物效果不良患者60例,以一次性电子微量泵吗啡静脉输注,按需要调整剂量,统计不良反应发生率并作相应对症处理.结果 不良反应发生率为呼吸抑制1.7%,头晕、嗜睡13.3%,恶心、呕吐15.0%,皮疹5.0%,尿潴留18.3%,便秘60.0%.所有不良反应经对症治疗后均明显缓解.未出现因不良反应而放弃治疗的病例.结论 大剂量吗啡静脉自控镇痛用于治疗癌痛的不良反应发生率虽较高,但对症治后均可缓解,无其他严重不良反应.

Evaluation of the Adverse Reaction and Treatment of Large Doses Morphine by Patient-controlled Intravenous Analgesia for Cancer Pain

Objective To evaluate the adverse reactions treatment measures of large doses morphine by patient-controlled intravenous analgesia in cancer pain treatment. Methods 60 eases cancer complicated with moderate-to-severe pain, poor effect for oral or intramuscular opioid drugs from Lunjiao Hospital, using morphine intravenous infusion by a one-time electronic micro pump, adjusted the dose aeec,rding to need were selected. The statistical analysis was used for adverse reaction incidence, symptomatic treatments were imple-mented. Results The adverse reactions incidence showed, respiratory depression was 1.7%, dizziness and sleepiness were 13.3%, nausea and vomiting were 15.0% , skin rash was 5.0% , urinary retention was 18.3% and constipation was 60.0% . All adverse reactions were obviously relieved after symptomatic treat-ments. No case forwent treatment because of adverse reactions. Conclusion The adverse reactions incidence of large doses morphine by patient-controlled intravenous analgesia in cancer pain treatment is high, but serious complications were infrequent, and can be obviously relieved after symptomatic treatments.