目的：评价应用自控镇痛微控皮下吗啡给药对晚期癌痛的疗效及安全性。方法对38例晚期癌痛口服阿片类药物效果不佳患者，应用吗啡自控镇痛泵以代替其口服吗啡用药，记录治疗前后疼痛评分（VAS）、生活质量评分-2（QOL-2）及24h吗啡总用量，观察疼痛缓解率及不良反应。结果应用镇痛泵前后VAS评分均值分别为（7.16±0.89）分和（1.79±0.38）分（P<0.01），QOL-2评分均值分别为（28.34±6.57）分和（50.03±8.41）分（P<0.01），治疗前后吗啡日用量分别为（92.60±21.01）mg（口服剂量）和（31.00±9.34）mg（皮下给药）（P<0.01）；疼痛缓解率为94.7%（36/38）；不良反应主要为便秘、恶心呕吐、尿潴留和精神症状。结论经皮下吗啡给药自控镇痛可有效控制晚期癌痛，具有安全、高效、方便等优点，并降低晚期癌痛患者吗啡药物用量及药物不良反应。%Objective To investigate the efficacy and safety of patient-controlled analgesia with percutaneous morphine pumping in patients with cancer pain. Methods Thirty-eight patients with cancer pain who had unsatis-factory outcome with opioids underwent continuous percutaneous morphine via patient-controlled analgesia pump from July 2012 to July 2013. The visual analogue scale(VAS) and quality of life(QOL) scale and morphine con-sumption within 24h were compared before and after treatment. The total rate of pain relief and adverse events were recorded. Results Before and after treatment,the VAS were 7.16±0.89 and 1.79±0.38, respectively (P<0.01), QOL were 28.34±6.57 and 50.03±8.41(P<0.01),and morphine consumption with 24 h were(92.6±21.01)mg (oral) and (31.0±9.34)mg (percutaneous)(P<0.01). The total rate of pain relief was 94.7%(36/38). The main adverse events was nausea,vomiting,constipation,urine retention,and mental symptoms. Conclusion Patient-controlled anal-gesia with continuously percutaneous morphine pumping is effective,safe,and convenient in treatment of cancer pain with smaller dosage and mild adverse events.
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