持续鞘内吗啡镇痛用于中重度腹部癌性内脏痛的疗效及安全性研究

目的 评价持续鞘内吗啡镇痛对于中重度晚期癌痛患者的疗效及安全性。方法 收集32例中重度晚期癌痛患者，体内植入鞘内导管外接电子PCA 泵实施持续鞘内吗啡镇痛，记录镇痛前后患者的VAS疼痛评分及QLQ-C30生活质量评分，同时观察不良反应。结果 32例患者使用鞘内镇痛后，经1周的剂量调整后，VAS评分为3.12±1.12，低于使用前的8.01±0.81（P＜0.05），QLQ-C30生活质量评分为45.52±3.34，较使用前的29.45±2.50显著提高（P＜0.05）。不良反应包括轻度皮肤瘙痒、便秘、头痛和尿潴留，全组患者均未出现呼吸抑制和鞘内感染。结论 持续鞘内吗啡镇痛效果确切，不良反应发生率低，费用低廉，操作方便，为晚期癌痛患者镇痛治疗的合理选择。

Efficacy and safety observation of continuous intrathecal morphine analgesia for moderate to severe abdominal visceral cancer pain

Objective To evaluate the efficacy and safety of continuous intrathecal morphine infusion therapy in patients with moderate to severe abdominal visceral cancer pain. Methods Thirty-two patients with moderate to severe abdominal visceral cancer pain were implanted with intrathecal catheter and connected with continuous external electronic PCA pump to implement intrathecal morphine analgesia, and the VAS score and the QLQ-C30 quality of life score before and after analgesic application were recorded. Adverse reactions were observed. Results After the application of continuous intrathecal morphine analgesia with 1 week dose adjust, the VAS pain score was 3.12 ± 1.12, lower than 8.01 ± 0. 81 before the application （ P 〈 0.05 ）, and the QLQ-C30 quality of life score was 45.52 ± 3.34, higher than 29. 45 ± 2. 50 before application （ P 〈 0.05 ）. No respiratory depression and intrathecal inflammation occurred in all patients; the adverse effects included pruritus, constipation, headache and urinary retention. Conclusion The effect of continuous intrathecal morphine infusion is effective, with low incidence of adverse reactions, low-cost and convenient operation, providing satisfied treatment for patients with moderate to severe cancer pain.