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目的观察硬膜外注射酚甘油治疗晚期癌痛的疗效及不良反应。方法选择失去手术机会或拒绝手术的晚期癌症患者42例,硬膜外间隙注射10％酚甘油镇痛,观察镇痛效果及并发症的发生。结果40例患者阻滞区域疼痛消失,占95．2％,其中有28例阻滞区域以外部位疼痛逐渐加剧,仍需依赖阿片类药物镇痛且用量渐增,1月后用量接近治疗前水平,仅12例治疗后阿片类药物用量显著减少。全组出现低血压、胃肠胀气、尿潴留、双下肢无力的比例分别为76．2％(32例)、85．7％(36例)、19．0％(8例)、14．3％(6例),但多在1周内消失。结论硬膜外注射酚甘油能有效消除阻滞区域的癌痛,长期并发症也较少发生,但单独应用本法难以取得满意的效果,综合治疗仍应成为晚期癌痛治疗的主要手段。
Objective To observe the efficacy and side effects of epidural injection of phenol and glycerol in the treatment of advanced cancer pain. Methods Forty-two patients with advanced cancer who lost their surgery or refused surgery were enrolled in this study. Epidural injection of 10% phenol-glycerol analgesia was used to observe the analgesic effect and complications. Results The pain disappeared in 40 cases, accounting for 95.2%. Among 28 cases, the pain outside the block was gradually aggravated. Still, opioid analgesia was still required and the dosage was gradually increased. The dosage was close to the pre-treatment level after 1 month , Only 12 cases of opioid consumption significantly reduced. The rates of hypotension, flatulence, retention of urine and weakness of both lower limbs were 76.2% (32 cases), 85.7% (36 cases), 19.0% (8 cases) and 14.3 % (6 cases), but more than 1 week disappear. Conclusion Epidural injection of phenolic glycerol can effectively eliminate the cancer pain in the blockade area, and long-term complications are rare. However, it is difficult to obtain satisfactory results with this method alone. Comprehensive treatment should be the main means of treatment of advanced cancer pain.