微囊肾上腺髓质嗜铬细胞蛛网膜下隙移植治疗晚期癌痛病人的疗效观察

目的:观察微囊肾上腺髓质嗜铬细胞移植到晚期癌痛病人蛛网膜下隙后的镇痛效果,并检测血儿茶酚胺浓度变化。方法:选择15例晚期癌症伴剧烈疼痛的病人,将经过提取、分离、纯化并以微囊包裹的牛肾上腺髓质嗜铬细胞移植到病人的蛛网膜下隙,移植后采用VAS法评价镇痛效果,并观察移植前后血中儿茶酚胺浓度变化、哌替啶用量改变及副作用。结果;移植后病人疼痛明显缓解,移植前后VAS有显著性差异(P<0.01)　显效率为26.7％,有效率为60％,总有效率为86.67％) 移植后血儿茶酚胺浓度与移植前相比具有显著性意义(P<0.01)移植后哌替啶用量明显低于移植前(P<0.01).结论:采用微囊肾上腺髓质嗜铬细胞蛛网膜下隙移植可明显缓解晚期癌痛病人疼痛,且副作用少。

Analgesic Effect of Transplantation of Micro-encapsulated Adrenal Medulla-chromaffin Cells to Subarachnoid Space on Patients with Advanced Cancer

Objective: To observe the analgesic effecl of transplantation of micro-encapsulated adrenal medulla-chromaffin cells to subarachnoid space on patients with advanced cancer. Methods: After extraction, separation and purification, the micro-encapsulated adrenal medulla-chromaffin cells were transplanted into the subarachnoid spaces in 15 patients with advanced cancer so as to evaluate their analgesic effects with visual analog scale (VAS) score. The changes of the concentration of cate-cholamine, the dosage and the side effect of pethidine were observed before and after the transplantation. Results: There were significant differences in VAS scores of analgesic effect, the concentrations of catechomine and the dosages of pethidine between pre-and post-transplantation (all P<0.01). Conclusion: The transplantation of micro-encapsulated adrenal medulla-chromaffin cells to subarachnoid space is able to obviously respite the pain in patients with advanced cancer and its side effect is slight.