CAJ | 학술논문

目的：观察吗啡静脉持续泵入法对重度癌性疼痛患者进行快速滴定的疗效和优势。方法：7例重度癌性疼痛患者，采用静脉输液泵（型号SY-1200），进行吗啡快速滴定。滴定前计算24h所需静脉吗啡的总量，以其总量的10%做为滴定的起始剂量。设定在15分钟内匀速静脉泵入，每隔15min评估疗效和不良反应，调整吗啡泵入速度。以疼痛评分降至1-3分的有效止痛剂量，然后计算24h所需吗啡的总量，最终制定个体化的止痛给药方案。结果：7例重度癌性疼痛患者均在24小时内完成了吗啡快速滴定，使疼痛评分降至1-3分；其中1例在滴定过程中嗜睡，及时下调剂量后，不良反应缓解。结论：采用吗啡静脉持续泵入的方法进行吗啡滴定可以迅速起效镇痛，明显缩短吗啡滴定时间，血清吗啡浓度可维持恒定有效水平，避免吗啡静推所致的波峰和波谷现象，并且不良反应可控，安全性强。
목적：관찰마배정맥지속빙입법대중도암성동통환자진행쾌속적정적료효화우세。방법：7례중도암성동통환자，채용정맥수액빙（형호SY-1200），진행마배쾌속적정。적정전계산24h소수정맥마배적총량，이기총량적10%주위적정적기시제량。설정재15분종내균속정맥빙입，매격15min평고료효화불량반응，조정마배빙입속도。이동통평분강지1-3분적유효지통제량，연후계산24h소수마배적총량，최종제정개체화적지통급약방안。결과：7례중도암성동통환자균재24소시내완성료마배쾌속적정，사동통평분강지1-3분；기중1례재적정과정중기수，급시하조제량후，불량반응완해。결론：채용마배정맥지속빙입적방법진행마배적정가이신속기효진통，명현축단마배적정시간，혈청마배농도가유지항정유효수평，피면마배정추소치적파봉화파곡현상，병차불량반응가공，안전성강。
Objective:To observe the effect and advantage of the morphine dosage titration via continuous intrave-nous infusion for the treatment of severe cancer pain. Methods:Seven patients with severe and prolonged pain were enrolled in the study. Titration:use intravenous infusion pump( type SY-1200)to give continuous intravenous mor-phine infusion. Titration of the starting dose was about 10% of the total morphine,which was the amount of 24h nee-ded intravenous morphine. Start pumping speed was determined,and the effect and adverse reactions were evaluated every 15min. So the speed of morphine pumping was adjusted. Then the amount of morphine for 24h can be calculat-ed,according morphine effective dose when pain score dropped to 1-3 points. Final individualized treatment of pain were established. Results:All 7 patients with severe cancer pain were quickly completed the morphine titration in 24 hours,whose NRS were declined to 1 -3. 1 case of drowsiness during the process of titration,the adverse reactions were eliminated after lower doses in a timely manner. Conclusion:The dosage titration of continuous intravenous mor-phine infusion can be maintained a constant level effectively,avoiding the phenomenon of peaks and troughs,and side effects can be controlled. This method is safe.