CAJ | 학술논문

目的：探讨居家晚期癌痛患者采用自控静脉镇痛(PCIA)治疗的可行性和有效性。方法32例Ⅳ期中重度癌性疼痛患者采用吗啡(初始给药剂量根据当时日口服吗啡总量1/3加上日肌注吗啡总量的2/3的2倍作为24 h泵注的连续背景输注剂量)+氟哌利多5 mg+胃复安40 mg用0.9%生理盐水配成100 ml，视患者镇痛效果调节药物浓度，病情需要可应用辅助药，如抗焦虑药/镇静催眠药、激素等。结果患者在PCIA镇痛期间疼痛明显缓解，治疗早期40.6%(13/32)的患者达到完全缓解，93.25%(30/32)的患者癌痛达到中度以上缓解，只有6.2%(2/32)的患者未达到满意效果。随着时间的延长，吗啡剂量的增大，平均初始剂量为(69.5±20.7) mg/d，治疗终点的剂量为(256.5±75.6) mg/d，平均治疗时间为(48.3±13.5) d，生活质量均有一定程度的改善，不良反应轻。结论居家晚期疼痛患者采用自控静脉镇痛治疗具有可行性，且疗效较好。
목적：탐토거가만기암통환자채용자공정맥진통(PCIA)치료적가행성화유효성。방법32례Ⅳ기중중도암성동통환자채용마배(초시급약제량근거당시일구복마배총량1/3가상일기주마배총량적2/3적2배작위24 h빙주적련속배경수주제량)+불고리다5 mg+위복안40 mg용0.9%생리염수배성100 ml，시환자진통효과조절약물농도，병정수요가응용보조약，여항초필약/진정최면약、격소등。결과환자재PCIA진통기간동통명현완해，치료조기40.6%(13/32)적환자체도완전완해，93.25%(30/32)적환자암통체도중도이상완해，지유6.2%(2/32)적환자미체도만의효과。수착시간적연장，마배제량적증대，평균초시제량위(69.5±20.7) mg/d，치료종점적제량위(256.5±75.6) mg/d，평균치료시간위(48.3±13.5) d，생활질량균유일정정도적개선，불량반응경。결론거가만기동통환자채용자공정맥진통치료구유가행성，차료효교호。
Objective To investigate the effects of patient-controlled intravenous analgesia treatment in pa-tients with advanced cancer. Methods 32 patients with moderate to severe periodⅣcancer pain were treated with morphine (initial dose of 24 h continuous background infusion was based on a summation of 1/3 of the 24h oral amount plus 2 times of 2/3 of intramuscular injection amount of morphine)+5 mg droperidol+40 mg metoclopramide paired with 100ml 0.9%saline. The drug concentration was adjusted according to the analgesic effects in patients. Ad-juvant drugs, such as anxiolytics, sedative hypnotics and hormones, were applied according to condition of patients. Results The pain was relieved in patients with PCIA, achieved complete remission in 40.6%(13/32) patients with early treatment, and achieved moderate remission in 93.25%(30/32) patients with cancer pain. Only 6.2%(2/32) pa-tients did not achieve satisfactory effect. With the extension of time, increasing doses of morphine, mean initial dose was (69.5±20.7) mg/d, the dose was (256.5±75.6) mg/d at the end of the treatment, and the average treatment time was (48.3±3.5) d. The quality of life was improved and adverse reactions were light. Conclusion Patient-controlled intra-venous analgesia is feasibility and effectiveness to treat advanced pain.