鞘内注药用于重度宫颈癌疼痛治疗的临床观察

目的观察鞘内注药治疗重度顽固性晚期宫颈癌疼痛患者的临床效果。方法选择60例ASAⅠ-Ⅲ级,经第二、三阶梯治疗效果欠佳重度晚期宫颈癌疼痛患者分为观察组（鞘内注药组）和对照组（美施康定组）,每组30例。观察组鞘内注药（硬膜外患者自控镇痛）每单元300 mL,混合液每单元药物含0.75%盐酸罗哌卡因60 mL,舒芬太尼300μg,氟哌啶5 mg、昂旦司琼20 mg,2 mL·h^-1泵注,对照组按照三阶梯规范口服硫酸吗啡控释片。运用视觉模拟评分法（VAS）评估治疗疗效,并不断调整治疗剂量。结果观察组患者经治疗后疼痛明显减轻,VAS为（1.86±1.42）分,生活质量明显改善,与镇痛前比较差异有显著的统计学意义（P〈0.01）,与对照组比较差异有统计学意义（P〈0.05）;部分患者可发生轻度的恶心呕吐,便秘,尿潴留等不良反应,无需特殊治疗。结论鞘内注药配合肿瘤化疗或放射治疗重度晚期宫颈癌疼痛患者效果满意、安全、不良反应少。

Intrathecal Injection for the Treatment of Severe Cervical Cancer Pain Clinical Observation

Objective Observation of intrathecal injections in treatment of severe intractable pain in patients with advanced cervical cancer clinical results.Methods 60 patients with ASA Ⅰ-Ⅲ grade,by the second and third step of severe ill treatment of advanced cervical pain were randomly divided into Group A（intrathecal injection group） and control group（of MS group） 30 cases.Intrathecal injection（epidural patient-controlled analgesia）300 mL perunit mixture containing 0.75% Ropivacaine 60 mL,Sufentanil 300 μg,Norfloxacin 5 mg,Ang Dan granisetron 20 mg,2 mL·h^-1 infusion.Control group,according to a three-tiered standard of oral morphine sulfate controlled release tablets.The use of visual analogue scales（VAS） assessment of treatment efficacy,and constantly adjust dosage.Results The patients significantly reduced pain after treatment,VAS was 1.86±1.42 points,quality of life improved significantly compared with the analgesia was significantly before the statistical significance of P〈0.01,compared with the control group was significantly P〈0.05;Some patients had mild nausea and vomiting,constipation,urinary retention and other side effects,no special treatment.Conclusion The intrathecal injection with chemotherapy or radiation treatment of severe pain in patients with advanced cervical cancer effect of satisfaction,safety,side effects.