摘要
目的观察吗啡联合氯胺酮皮下自控镇痛（PCSA）治疗顽固性中、重度癌痛的效果及安全性。方法选择60例中、重度癌痛患者，按数字表法随机分成两组（Ⅰ组和Ⅱ组各30例），Ⅰ组采用吗啡PCSA治疗，Ⅱ组采用小剂量氯胺酮联合吗啡PCSA治疗，两组治疗后1h、24h、48h采用视觉模拟评分法（VAS）评估疼痛程度，采用t检验分析比较两组镇痛效果、采用χ^2检验分析比较两组不良反应发生情况。结果两组治疗后1h、24h、48hVAS评分差异均无统计学意义（均P〉0．05），但Ⅱ组吗啡用量平均31．23mg明显少于Ⅰ组的56．43mg（χ^2=6．18，P〈0．05）；Ⅱ组恶心呕吐4例（13．3％）、便秘2例（6．7％）、嗜睡2例（6．7％）、皮肤瘙痒0例（0．0），明显低于Ⅰ组的21例（70．0％）、18例（60．0％）、9例（30．0％）、8例（26．7％）（χ^2=8．96、5．63、3．32、8．67，均P〈0．05）。结论吗啡联合小剂量氯胺酮PCSA具有镇痛作用强、不良反应小等优点，适合治疗中、重度顽固性癌痛。
Objective To observe the analgesic effects and safety of morphine combined low-dose ketamine with patient control subcutaneous analgesia（PCSA） for patients with moderate to severe late cancer pain. Methods 60 patients with moderate to severe late phase cancer pain were randomly average divided into two groups （ group Ⅰ and group Ⅱ ）. 30 patients of group Ⅰ were treated with morphine PCSA and 30 patients of group Ⅱ were treated lowdose ketamine plus morphine PCSA, respectively. The VAS（ Visual Analogue Scale） of pain scores were evaluated after treatment 1 h,24 h,48 h. Effects and the rate of side effects were also comparred. Results There was no significant difference in VAS pains scores in each period. Morphine dosage in group Ⅰ （56.43 mg） was significantly more than that in group Ⅱ （31.23mg） （χ^2 = 6. 18,P 〈 0. 05 ）. Group Ⅱ ：The incidence of nausea or vomiting was 4cases （ 13.3 % ）, constipation was 2 cases （ 6. 7 % ）, drowsiness was 2cases （ 6. 7 % ）, skin titillation was 0 （0.0） ; but Group Ⅰ of it was 21 （ 70. 0% ） , 18 （ 60. 0% ）, 9 （ 30. 0% ） , 8 （ 26. 7% ） , The incidence of group Ⅱ was lower than group Ⅰ . Conclusion Small dosage ketamine combined with morphine patient control subcutaneous analgesia （PCSA） approach appears to provide a safe and effective method for advanced cancer patients with moderate to severe pain.
出处
《中国基层医药》
CAS
2010年第8期1053-1054,共2页
Chinese Journal of Primary Medicine and Pharmacy
关键词
疼痛
肿瘤
镇痛
病人控制
氯胺酮
吗啡
Pain
Neoplasms
Analgesia, patient-controued
Ketamine
Morphine
