晚期消化系统肿瘤疼痛患者大剂量吗啡治疗的临床护理研究  

The study on clinical nursing of patients with large doses of morphine in treatment of advanced digestive system cancer pain

作　　者：刘雪融[1] 王艳[1] 朱秋明[1] 张彩滨 越晓琳 

机构地区：[1]哈尔滨医科大学附属第一临床医院,哈尔滨150001

出　　处：《中国肿瘤临床与康复》2014年第8期998-999,共2页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：国家临床重点专科建设项目经费资助(编号2012-649)

摘　　要：目的探讨晚期消化系统肿瘤疼痛患者大剂量吗啡治疗及护理的临床疗效。方法选择2010年6月至2013年6月接受大剂量吗啡治疗的晚期消化系统肿瘤疼痛患者34例,所有患者均给予大剂量吗啡静脉输液泵输入治疗,起始剂量为为口服剂量的30%,效果不显著者适当增加吗啡剂量,吗啡剂量220-550mg/d,对患者进行静脉输注泵、输液管、镇痛、不良反应等护理,观察疗效。结果疼痛完全缓解18例（52.9%）,部分缓解16例（47.1%）,疼痛缓解有效率为100%。在治疗过程中,出现轻微头昏嗜睡、恶心呕吐、血压降低、呼吸抑制、便秘、幻觉谵妄、欣快感等不良反应,经对症治疗、减少吗啡剂量以及时间延长后,不良反应均显著减轻或消失。结论晚期消化道肿瘤疼痛患者使用大剂量吗啡治疗与护理,能有效缓解患者极度疼痛,提高生活质量,值得临床推广应用。Objective To study the clinical effect of large doses of morphine for patients with advanced digestive system cancer pain. Methods 34 patients hospitalized from June 2010 to June 2013 with advanced digestive system cancer pain were selected and received treatment of large dose of morphine （ dose 220 -550mg/d） with the infusion pump. Infusion pump, infusion tube, analgesia and adverse reactions were nursed,and observed the curative effects were observed. Results 18 cases with complete pain relief accounted for 52. 9% ,and 16 cases with the partial pain relief 47.1%. The effective rate of the pain relief reached 100. 0%. In the course of treatment, the adverse reactions such as mild dizziness, nausea and vomiting, lethargy, decreased blood pressure, respiratory depression, hallucinations, delirium, euphoria, constipation significantly decreased with symptomatic treatment, morphine dose reduced or the time extended. Con- clusion Using high doses of morphine in the treatment and care of the patients with advanced digestive tract cancer pain could effectively alleviate extreme pain, improve the quality of life, which was worthy of further clinical application.

关 键 词：大剂量吗啡 晚期消化系统肿瘤 疼痛 护理 

分 类 号：R735[医药卫生—肿瘤]