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目的对比不同浓度酚甘油胸段硬膜外注射治疗晚期癌痛的镇痛效果。方法选择WHO 三阶梯止痛第三级药物治疗效果差的胸部、中上腹部或背部疼痛(VAS评分法均为8-10)的癌症患者60 例,随机分为A、B、C 3组。根据疼痛部位确定穿刺点行硬膜外穿刺,先注入1.5%利多卡因3-5ml,观察5min,无全脊麻症状,1次分别注入5%(A组)、10%(B组)、15%(C组)酚甘油溶液3-5ml。结果近期(24 h)镇痛效果C组明显优于A组(P<0.01),B组优于A组(P<0.05)。远期镇痛效果优良率高浓度组大于低浓度组,但无统计学意义。结论15%酚甘油胸段硬膜外注射用于晚期癌痛的镇痛效果优于低浓度组,且不增加并发症。
Objective To compare the analgesic effect of epidural injection of phenol glycerin thoracic epidural to treat advanced cancer pain. Methods Sixty cancer patients with chest, mid-upper abdomen or back pain (8-10 VAS score) with poor third-class WHO three-step analgesic therapy were randomly divided into A, B and C groups. According to the site of pain, the epidural puncture point was used for epidural puncture. First, 3-5ml of 1.5% lidocaine was injected for 5 minutes, without any symptoms of spinal anesthesia. The patients were injected with 5% (A) and 10% (B) 15% (Group C) phenol glycerol solution 3-5ml. Results The analgesic effect of group C was better than group A in 24 h (P <0.01), and group B was superior to group A (P <0.05). Long-term good analgesic effect of high-concentration group was higher than the low-concentration group, but not statistically significant. Conclusion 15% phenol-glycerol thoracic epidural injection of advanced cancer pain analgesic effect is better than the low concentration group, and does not increase the complications.