PVB联合PCIA治疗爆发性癌痛的临床疗效观察

Clinical effects of PVB combined with PCIA in the treatment of breakthrough cancer pain

关键词:  椎旁神经阻滞  静脉自控镇痛  爆发性癌痛

Key words:  paravertebral block(PVB)  patient-controlled intravenous analgesia (PCIA)  breakthrough cancer pain(BTCP)

摘要:

[目的] 探讨PVB联合PCIA治疗爆发性癌痛(BTCP)的临床疗效。[方法] 对29例临床分期为Ⅳ期且常规应用吗啡镇痛效果不佳的癌痛患者，采用PVB与PCIA联合的方法进行镇痛治疗，观察疼痛程度(PI)及疼痛缓解程度(PAR)，并记录BTCP出现的频率。[结果] 联合镇痛治疗前的BTCP平均间隔时间(h)及24 h内出现次数分别为9.29±3.6、3.21±1.26，与治疗后的24.69±8.09、0.86±0.74比较差异有显著性意义(P<0.05)；联合治疗前的疼痛评分为8.89±0.817，与治疗后的1.79±1.677比较差异有显著性意义(P<0.05)。[结论] PVB联合PCIA镇痛方法可以显著降低BTCP出现的频率，提高了晚期癌痛患者的生活质量，具有临床应用的可行性。

Abstract:

[Objective] To explore clinical effects of Paravertebral block (PVB) combined with morphine patient-controlled intravenous analgesia(PCIA) in the treatment of breakthrough cancer pain(BTCP). [Method] For the clinical stage Ⅳ cancer patients of poor analgesic effect by routine application of morphine, the combined analgesic method was been used, to observe pain intensity (PI) and the degree of pain relief (PAR), and record the frequency of BTCP. [Result] Before the combined analgesic method, the average interval time(hour) of BTCP and the number of occurrence frequency within 24 hours were 9.29±3.6, 3.21±1.26, after then were 24.69±8.09, 0.86±0.74. There were significant differences (P<0.05)；The pain score before the combined analgesic method was 8.89±0.817, after then was 1.79±1.677. There were significant differences (P<0.05). [Conclusion] The treatment of PVB combined with PCIA could significantly reduce the frequency of BTCP in the advanced cancer patients with severe pain, and improve their quality of life. For the more, it was the feasibility of clinical application.