椎管内转移癌病人氨甲喋呤配伍高渗盐水硬膜外灌注治疗顽固性疼痛的临床探讨

１０例椎管内转移癌病人曾长期使用大剂量镇痛药难以奏效，而少数病例便采用硬膜外腔注射吗啡２～４ｍｇ疼痛缓解仅１ｈ。采用硬膜外腔灌注氨甲喋呤配伍高渗盐水，使抗癌药直接与肿瘤接触，几分钟内杀死癌细胞，加之高渗盐水能促使肿瘤和神经干脱水，肿瘤体积缩小和破坏，改善局部动脉缺血和组织水肿，从而减轻或消除肿瘤对神经根的压迫，缓解和消除神经痛。

Epidural Metrotrexate with Hyperitonic Salina for Pain Control of Introspinal Mestastatic Cancers

The efficiency of methotrexate(MTX),an anticarcinogen,and hyperitonic saline of epidurally-injected for pain-relief were studied in 10 patients with introspinal mestastatic cancers.The patients had been adminitered high dose of analgesics for a long term and their cancer pain was hardly controlled.The analgesic duration of epidural morphine,which was used in some of the patients,was only about 2 hours,In this study,epidural MTX could contact and kill cancer cells directely in a few minutes,and the hyperitonic saline could promote the debydration of cancer tissue and nerves,thus minimizing or distroying the cancer mass and improving the local ischemia and edema. As a result, the pressure on the nerves could be removed and the severly progressive nerve pain could be relieved.It is coulded that epidurall MTX with hyperitonic saline in this kind of patients is a valuable selection of pain control,especially in the situation in which other methods are no longer effective.