椎旁神经阻滞在晚期顽固性癌痛中的临床研究  

Clinical Research of Paravertebral Block in the Treatment of Advanced Refractory Cancer Pain

作　　者：张海琛[1] 郑进[1] 李杰[1] 李大伟[1] 

机构地区：[1]大连医科大学附属二院肿瘤放疗科,辽宁大连116027

出　　处：《医学与哲学（B）》2012年第7期16-18,共3页Medicine & Philosophy(B)

摘　　要：研究椎旁神经阻滞在晚期顽固性癌痛中对吗啡静脉自控镇痛的影响。将晚期顽固性癌痛患者随机分为两组,每组12例,M组、PM组分别采用吗啡静脉自控镇痛及椎旁神经阻滞联合吗啡静脉自控镇痛的方法,记录治疗前、治疗后3、6、12、24、48、72小时疼痛的视觉模拟评分及72小时时的吗啡总用量。镇痛治疗后第3、6、12、24、48小时的VAS评分,PM组明显小于M组(P<0.05),而治疗72小时两组疼痛的视觉模拟评分无显著差异;72小时吗啡消耗总量两组存在显著差异(P<0.01),M组明显高于PM组。在晚期顽固性癌痛达到重度时,椎旁神经阻滞与吗啡静脉自控镇痛相结合的方法镇痛效果更好,并可减少吗啡用量。To research the effect of paravertebral block in advanced refractory cancer pain with morphine patient--controlled intravenous analgesia. The patients of advanced refractory cancer pain were randomly divided into two groups. There are 12 patients in each group. Morphine PCIA and PVB combined with morphine PCIA were used in group M and group PM, re- corded VAS scores before treatment, after treatment 3,6,12,24,48,72 hours and total morphine dose in 72 hours. The VAS score in group PM after treatment 3,6,12,24,48 hours were significantly less than group M { P^0.05}, but there was no significant difference between two groups at 72h after treatment. The total consumption of morphine was significant differences between the two groups （P^0. 01} ,and the group M was significantly higher than the group PM. To appear severe pain in the patients of advanced refractory cancer, the analgesic effect of PVB combined with morphine PCIA was better than morphine PCIA. In addition, this method could reduce the amount of morphine.

关 键 词：椎旁神经阻滞 吗啡静脉自控镇痛 晚期顽固性癌痛 

分 类 号：R614.4[医药卫生—麻醉学]