持续鞘内吗啡联合罗哌卡因用于中、重度晚期癌痛患者的疗效观察

摘要

目的：探讨持续鞘内吗啡联合罗哌卡因用于中、重度晚期癌痛患者的疗效。方法：选择60例2014年1月-2015年5月于本院住院治疗的中、重度晚期癌痛的患者作为研究对象，按照随机数字表法将患者分为对照组和观察组，每组各30例。两组患者在治疗初期均实行鞘内导管植入并外接PCA电子泵进行连续鞘内镇痛措施，其中对照组在治疗过程中给予浓度为0.2 mg/mL的纯吗啡溶液泵入，而观察组则给予浓度为0.2 mg/mL的吗啡溶液+2 mg/mL罗哌卡因混合液泵入。观察两组患者术后镇痛效果及用药后的不良反应的发生率。结果：经过统计分析发现，两组用药后均起到一定的镇痛效果，但观察组患者镇痛效果（VAS评分）和对照组相比明显降低，差异有统计学意义（P<0.05）；用药后两组患者均出现不同程度的不良反应，但两组患者不良反应的发生率比较差异无统计学意义（P>0.05）。结论：对于中、重度晚期癌痛患者在口服吗啡无效的情况下给予吗啡联合罗哌卡因混合液持续鞘内泵入，不仅能够起到较好的镇痛效果，并且安全可靠，值得在以后的工作中广泛应用。%Objective:To explore the efficacy of continuous intrathecal Morphine and Ropivacaine used in patients with moderate or severe advanced cancer pain.Method: 60 patients in our hospital with moderate or severe advanced cancer pain from January 2014 to May 2015 were selected and randomly divided into control group and observation group according to a random number table, each group contained 30 cases. In the early treatment, both of the two groups were applied continuous intrathecal analgesia by implanting intrathecal catheter and connecting external electronic PCA pump, the control group was pumped pure Morphine (0.2 mg/mL), the observation group was pumped Morphine (0.2 mg/mL) and Ropivacaine (0.2 mg/mL), and the postoperative analgesia and incidence of adverse reactions were compared.Result:After statistical analysis, both of the two groups cancer pain reduced, but analgesia (VAS score) of the observation group was significantly lower than that of the control group, the difference between the two groups was statistically significant (P<0.05). After treatment, both of the two groups had adverse reactions, but there was no significantly significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion: If there is no effect for moderate and severe advanced cancer patients by giving oral morphine, continuous intrathecal morphine and ropivacaine not only can reduce the patients’ cancer pain, but also have a good safety, so it is worth to promoted.