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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。
OBJECTIVE: To observe the analgesic effect of chromaffin cell transplantation into the subarachnoid space of patients with advanced cancer pain and to detect the change of blood catecholamine concentration. METHODS: Fifteen patients with advanced cancer accompanied by severe pain were selected and the bovine adrenal medullary chromaffin cells, which had been extracted, isolated, purified and encapsulated, were transplanted to the patient’s subarachnoid space. The VAS method was used to evaluate the analgesia Effect, and observe the blood catecholamine concentrations before and after transplantation, pethidine dosage changes and side effects. Results: The postoperative pain relief was significantly relieved. There was a significant difference in VAS before and after transplantation (P <0.01). The effective rate was 26.7%, the effective rate was 60% and the total effective rate was 86.67% (P <0.01), the dosage of pethidine was significantly lower than that before transplantation (P <0.01) .Conclusion: The use of microcephalic adrenal medullary chromaffin subarachnoid transplantation can significantly relieve pain in patients with advanced cancer pain , And less side effects.