重度癌痛患者行持续静脉吗啡泵注快速滴定的临床效果观察

Rapid titration with continuous intravenous infusion of morphine in patients with severe cancer pain

摘要:

目的：探讨静脉吗啡泵对重度癌痛患者的临床治疗效果。方法： 入组82例癌痛患者,疼痛NRS≥7分,于2018年2月至2019年5月入住我科治疗疼痛,采用药物输注泵静脉泵注吗啡快速滴定止痛,起始剂量依据前期口服阿片类药物量个体化确定,观察指标为治疗前后的静息疼痛评分、运动疼痛评分、心理状况评分、生活质量评分及不良反应发生情况。结果：治疗后各项观察指标均优于治疗前,数据差异有统计学意义(P＜0.05),不良反应患者3例,均在减量后好转。结论：在临床治疗晚期癌痛患者重度疼痛时,可行持续静脉吗啡泵注快速滴定的方法来迅速有效的缓解患者的疼痛症状,操作过程易于控制的同时也尽可能的减少了不良反应的发生,改善患者的治疗预期,适合临床应用。

Abstract:

objective: This paper explores the clinical effect of intravenous morphine infusion through drug infusion device applied to patients with severe cancer.Method: 82 cases with severe cancer who were hospitalized from February 2018 to May 2019 to treat the pain were selected as observation objects. The rapid titration of continuous intravenous morphine infusion through drug infusion pump was adopted for the treatment of pain. The initial dose was determined by the previous dose of orally-taken opioid. The observation indexes were the tranquillization pain score, the exercise pain score, the psychological status score, the life quality score and the adverse reaction before and after the treatment.Results: The observation indexes after treatment were all better than those before the treatment and the data difference is of statistical significance (P＜0.05). There were 3 cases of adverse reactions but they all got improved after reduction of dosage.Conclusion: In the clinical treatment of the severe pain in patients with advanced cancer, it is applicable to conduct rapid titration of continuous intravenous morphine infusion to effectively relieve the patients’ symptom of pain. The operation process is easy to control and it can also minimize the occurrence of adverse reactions and improve the treatment expectation of patients, which makes it suitable for clinical application.