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目的总结吗啡静脉自控镇痛(PCIA)在晚期癌性疼痛治疗中应用经验。方法40例Ⅳ期中到重度癌性疼痛患者静脉输入吗啡治疗,采用视觉模拟评分法(VAS)或0~10数字疼痛强度分级法(NRS)对疼痛程度进行评估,使用生活质量(QOL)评价,观察记录不良反应。结果大部分患者在PCIA镇痛期间,疼痛明显缓解,但随着时间的延长,吗啡剂量的增大,平均初始剂量为(70.4±21.7)mg/d,治疗终点的剂量为(286.3±95.5)mg/d,平均治疗时间(38.3±12.1)天。生活质量均有一定程度的改善,不良反应较轻。结论PCIA可安全用于晚期癌性疼痛治疗,具有使用方便、疗效确定、不良反应轻等优点。
Objective To summarize the experience of morphine intravenous controlled analgesia (PCIA) in the treatment of advanced cancerous pain. Methods Forty patients with stage Ⅳ moderate to severe cancerous pain were treated with intravenous morphine, and visual analog scale (VAS) or 0 ~ 10 digital pain intensity grading (NRS) were used to evaluate the pain degree. Quality of life (QOL) Observation and record adverse reactions. Results Most of the patients had relieved pain during the PCIA analgesia. However, with the prolongation of time, the average initial dose of morphine was (70.4 ± 21.7) mg / d and the final dose was (286.3 ± 95.5) mg / d, the average treatment time (38.3 ± 12.1) days. The quality of life improved to some extent with mild adverse reactions. Conclusion PCIA can be safely used in the treatment of advanced cancerous pain, with the advantages of convenient use, definite curative effect and light adverse reactions.