CAJ | 학술논문

目的：评价应用无线镇痛系统微控皮下吗啡给药对难治性癌痛的疗效及安全性。方法选择2013年2~10月在本院接受无线镇痛系统及终端电子泵持续皮下泵注吗啡治疗的19例难治性癌痛患者以代替其口服吗啡药物，观察疼痛缓解时间、程度及缓解率与给药调整完成时间和不良反应，并记录比较治疗前后3d疼痛评分(VAS﹚及24 h吗啡总用量。结果使用镇痛泵后平均疼痛缓解时间35 min；应用镇痛泵前后VAS评分分别为7(1﹚分和1(1﹚分(P﹤0.01﹚，治疗前后吗啡日用量分别为(92.6±21.3﹚mg(口服剂量﹚和(31.0±9.34﹚mg(皮下给药﹚(P﹤0.01﹚；治疗后各观察点间VAS评分与吗啡用药量比较无显著差异；疼痛缓解率为94.7%(18/19﹚，平均给药量调整完成时间38.4 h；不良反应发生主要为便秘、恶心呕吐、尿潴留和精神症状。结论无线镇痛系统皮下吗啡给药可有效控制难治性癌痛，具有安全、高效、方便、稳定持久的优点，并降低难治性癌痛患者的吗啡药物的用量。
목적：평개응용무선진통계통미공피하마배급약대난치성암통적료효급안전성。방법선택2013년2~10월재본원접수무선진통계통급종단전자빙지속피하빙주마배치료적19례난치성암통환자이대체기구복마배약물，관찰동통완해시간、정도급완해솔여급약조정완성시간화불량반응，병기록비교치료전후3d동통평분(VAS﹚급24 h마배총용량。결과사용진통빙후평균동통완해시간35 min；응용진통빙전후VAS평분분별위7(1﹚분화1(1﹚분(P﹤0.01﹚，치료전후마배일용량분별위(92.6±21.3﹚mg(구복제량﹚화(31.0±9.34﹚mg(피하급약﹚(P﹤0.01﹚；치료후각관찰점간VAS평분여마배용약량비교무현저차이；동통완해솔위94.7%(18/19﹚，평균급약량조정완성시간38.4 h；불량반응발생주요위편비、악심구토、뇨저류화정신증상。결론무선진통계통피하마배급약가유효공제난치성암통，구유안전、고효、방편、은정지구적우점，병강저난치성암통환자적마배약물적용량。
Objective To evaluate the efficacy and safety of wireless analgesia system percutaneous morphine pumping in patients with refractory cancer pain. Methods A total of 19 patients with refractory cancer pain underwent continu-ous percutaneous morphine via wireless patient-controlled analgesia pump to replace the oral morphinefrom Feb 2013 to Oct 2013 were included. Recorded the pain relief time,degree and remission rate,dosing adjustment completion time and adverse reactions. And compare visual analogue scale(VAS﹚before and after 3 days and morphine consumption 24 hours of total. Results The average time of beginning of pain relief was 35 min. The VAS before and after treatment were 7(1﹚and 1(1﹚respectively(P﹤0.01﹚, morphine consumptions were (92.6±21.3﹚mg and (31.0±9.34﹚mg. The de-gree of pain relief was 94.7%(18/19﹚. The average completion time of morphine titration was 38.4 hours. The main adverse reaction of constipation,nausea and vomiting,urinary retention and psychiatric symptoms were recorded. Conclusion Wireless analgesia system continuous percutaneous morphine pumping can effectively control the in-tractable cancer pain, is safe, efficient, convenient, and reduce morphine refractory cancer pain patientsdosage.