胸段硬膜外注射酚甘油治疗晚期癌痛  

Analgesic effect of thoracic epidural phenol glycerin on the terminal cancer pain.

作　　者：殷振奎[1] 牛爱清 

机构地区：[1]山西省长治医学院附属和济医院麻醉科,046011 [2]长治北铁路医院麻醉科,046021

出　　处：《实用疼痛学杂志》2005年第3期158-160,共3页Pain Clinic Journal

摘　　要：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 phenol glycerin of different concentration in thoracic epidural space on terminal cancer pain. Methods Sixty cancer patients who had inefficient pain relief (VAS 8-10) with WHO third ladder medication in thorax, abdomen or back area were randomly divided into three groups, injecting epidurally 5%(A), 10%(B), 15%(C) phenol glycerin 3-5 ml. Results The analgesic effect of group C in the near period(24hours) were obviously excellent than that of group A (P<0.01) and group B were also excellent than group A (P<0.05).The effective rate of the high concentration group in long-term were better than that of the low concentration group,but had no statistically significant. Conclusion The analgesic effect of injecting phenol glycerin (15%) in the epidural space on the terminal cancer pain is better than that of low concentration with no increasing complications.

关 键 词：晚期癌痛 硬膜外注射 甘油治疗 胸段硬膜外 镇痛效果 三阶梯止痛 硬膜外穿刺 酚甘油 注射治疗 不同浓度 治疗效果 方法选择 癌症患者 背部疼痛 疼痛部位 利多卡因 低浓度 WHO 评分法 上腹部 穿刺点 全脊麻 优良率 统计学 

分 类 号：R730.5[医药卫生—肿瘤] R614.42[医药卫生—临床医学]