患者自控皮下镇痛在中重度癌性疼痛患者中应用

目的探讨患者自控皮下镇痛(PCSA)在中重度癌性疼痛患者中应用的有效性和安全性。方法回顾性分析自2010年9月至2014年8月中国医科大学附属第一医院和第四医院收治的121例中重度癌性疼痛患者的临床资料。根据镇痛方法不同,分为PCSA镇痛(PCSA组)31例,口服吗啡缓释片镇痛(吗啡组)50例,芬太尼透皮贴镇痛(芬太尼组)40例。对比分析各组患者镇痛效果和镇痛相关并发症的发生率。结果 PCSA组患者恶心呕吐、便秘、爆发性疼痛发生率明显低于吗啡组及芬太尼组,差异均有统计学意义(P<0.05)。PCSA组患者镇痛后1周VAS评分与吗啡组及芬太尼组比较,差异均有统计学意义(P<0.05)。结论 PCSA尽管便携度略逊一筹,但其可为中重度癌性疼痛患者提供恒定满意的镇痛效果,值得在临床中推广。

Clinical application of PCSA for moderate and severe cancer pain

Objective To evaluate the analgesic effect and safety of patient control subcutaneous analgesia( PCSA) for moderate/se-vere cancer pain patients. Methods Totally 121 cases with moderate/severe cancer pain were retrospectively analyzed in The First and Fourth Hospital Affiliated to China Medical University from September 2010 to August 2014. According to different analgesic meth-ods,121 cases were divided into 31 cases of PCSA analgesia(PCSA group),50 cases of zyban oral morphine analgesia(morphine group),and 40 cases of fentanyl transdermal stick analgesia(fentanyl group). Comparative analysis was performed in patients among the three groups for the analgesic effect of the incidence of complications associated with pain. Results In PCSA group,the incidence of nausea and vomiting,constipation,explosive pain was obviously lower than that of morphine and fentanyl groups,and the differences were statistically significant(P<0. 05). VAS score of PCSA group at 1 week postoperatirdy was statistically lower than those of mor-phine and fentanyl groups(P<0. 05). Conclusion PCSA may provide a satisfactory and constant analgesic effect. Although it is in-convenient sometimes,it is worthy spreading in the clinical practice.