氢吗啡酮鞘内自控镇痛治疗难治性癌痛的临床研究  

EFFICACY OF PATIENT SELF-CONTROLLED INTRATHECAL HYDROMORPHONE INFUSION IN TREATMENT OF REFRACTORY CANCER PAIN

作　　者：王伟宁 陈晓彤 陈付强[3] 于洋[3] 孙明洁[3] WANG Wei-Ning;CHEN Xiao-Tong;CHEN Fu-Qiang;YANG YU;SUN Ming-Jie(Department of Pain Medicine,Shanxian Central Hospital,Shanxian 274300,China;School of Clinical Medicine,Jining Medical College,Jining 272067,China;Department of Pain Medicine,Qingdao Municipal Hospital,Qingdao 266000,China)

机构地区：[1]单县中心医院疼痛科,单县274300 [2]济宁医学院临床学院,济宁272067 [3]青岛市市立医院疼痛科,青岛266011

出　　处：《中国疼痛医学杂志》2018年第7期517-521,共5页Chinese Journal of Pain Medicine

摘　　要：目的:观察鞘内氢吗啡酮自控镇痛治疗难治性癌痛的疗效。方法:选取难治性癌性疼痛病人40例,行鞘内输注港植入术。观察并记录病人鞘内治疗前后视觉模拟评分法(visual analogue scale,VAS)评分、淋巴细胞亚群、SF-36健康调查简表(the MOS 36-Item Short Form Health Survey,SF-36)生活质量评分、便秘的发生率进行自身对照研究。结果:氢吗啡酮鞘内自控镇痛后(T1,T2)病人VAS疼痛评分与(T0)相比明显降低(P<0.01);SF-36生活质量评分(T2)较术前(T0)有明显改善(P<0.001);CD_3^+、CD_4^+、CD_4^+/CD_8^+以及NK细胞水平(T2)较术前(T0)有改善(P<0.05);鞘内镇痛便秘发生率较术前显著降低(P<0.001)。结论:氢吗啡酮鞘内自控镇痛治疗难治性癌性疼痛能改善病人的疼痛、生活质量和免疫状态,降低便秘发生率。Objective:To observe the clinical efficacy of patient self-controlled intrathecal hydromorphone infusion in the treatment of refractory cancer pain compared with oral morphine.Methods:The intrathecal infusion system was implanted in 40 patients who were admitted for treatment of severe cancer pain in operation room.Visual analogue scale(VAS),the cell counts of T lymphocyte subsets,SF-36 scores and the incidence of constipation were recorded before and after intrathecal infusion therapy for self-control study.Result:The VAS scores of all of the patients treated with intrathecal hydromorphone infusion at T1,T2 were lower compared with that at T0(P<0.01);The SF-36 scores of all of the patients at T2 were higher than that at T0(P<0.001);The T lymphocyte subsets CD3^+,CD4^+,CD4^+/CD8^+and NK cells at T2 were higher than that at T0(P<0.05);The incidences of constipation at T2 were lower than that at T0(P<0.001).Conclusion:Patient self-controlled intrathecal hydromorphone infusion can significantly reduce the cancer pain,improve patients'quality of life and immune status,and reduce the incidence of constipation.

关 键 词：鞘内输注 难治性癌性疼痛 氢吗啡酮 免疫状态 

分 类 号：R730.5[医药卫生—肿瘤]