吗啡经蛛网膜下腔植入式输注系统治疗晚期癌痛的临床观察

目的观察经蛛网膜下腔植入式输注系统输注吗啡在晚期癌痛患者镇痛的疗效。方法晚期癌痛住院患者25例，通过蛛网膜下腔植入式输注系统输注吗啡镇痛，观察治疗前与吗啡输注后24h、72h、1周、1月的VAS评分、睡眠质量（Qs）、毒副反应。结果1月后疼痛控制程度达优者22例（88％），良1例（4％），一般1例（4％），差1例（4％）；优良率为92％。睡眠质量优22例（88％），良3例（12％）。毒副反应有皮肤瘙痒2例（8％），恶心3例（12％），便秘3例（12％），尿潴留4例（16％），未见嗜睡和呼吸抑制者。结论经蛛网膜下腔植入式输注系统输注吗啡对晚期癌痛患者的镇痛疗效确切，不良反应少。

Infusion of morphine by subarachnoid space implantable pump in the treatment of patients with advanced cancer pain

Objective To observe the efficacy of subarachnoid space implantable morphine pump in patients with advanced cancer pain. Methods Twenty-five patients with advanced cancer pain were treated by continuous infusion of morphine with subarachnoid space implantable morphine pump. The analgesic efficacy was evaluated with visual analogue scale, sleeping quality and side reac- tions at pre-treatment and 24, 72 h, 7days and one month after the treatment. Results After a month, the efficacy of 22 cases （88%） was excellent, 1 case （4%） good, 1 case （4%） effective and 1 case （4%） poor. The excellent and good rates were 92%. Excellent quality of sleep was in 22 cases （88%）, good was in 3 eases （12M）. The side reactions included skin itching in 2 cases （8%）, nau- sea in 3 cases （12%）, constipation in 3 cases （12%）, urinary retention in 4 cases （16%）, no lethar gy and respiratory depression. Conclusion With less side-reactions, the effect of suharachnoid implanted morphine pump in the treatment of patients with advanced cancer pain is definite.