【摘要】 目的:观察鞘内氢吗啡酮自控镇痛治疗难治性癌痛的疗效。方法:选取难治性癌性疼痛病人40例,行鞘内输注港植入术。观察并记录病人鞘内治疗前后视觉模拟评分法（visual analogue scale,VAS）评分、淋巴细胞亚群、SF-36健康调查简表（the MOS 36-Item Short Form Health Survey,SF-36）生活质量评分、便秘的发生率进行自身对照研究。结果:氢吗啡酮鞘内自控镇痛后（T1,T2）病人VAS疼痛评分与（T0）相比明显降低（P<0.01）;SF-36生活质量评分（T2）较术前（T0）有明显改善（P<0.001）;CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺以及NK细胞水平（T2）较术前（T0）有改善（P<0.05）;鞘内镇痛便秘发生率较术前显著降低（P<0.001）。结论:氢吗啡酮鞘内自控镇痛治疗难治性癌性疼痛能改善病人的疼痛、生活质量和免疫状态,降低便秘发生率。更多还原

【Abstract】 Objective: To observe the clinical efficacy of patient self-controlled intrathecal hydromorphone infusion in the treatment of refractory cancer pain compared with oral morphine. Methods: The intrathecal infusion system was implanted in 40 patients who were admitted for treatment of severe cancer pain in operation room. Visual analogue scale（VAS）, the cell counts of T lymphocyte subsets, SF-36 scores and the incidence of constipation were recorded before and after intrathecal infusion therapy for self-control study. Result: The VAS scores of all of the patients treated with intrathecal hydromorphone infusion at T1, T2 were lower compared with that at T0（P < 0.01）; The SF-36 scores of all of the patients at T2 were higher than that at T0（P < 0.001）; The T lymphocyte subsets CD₃⁺, CD₄⁺, CD₄⁺/CD₈⁺ and NK cells at T2 were higher than that at T0（P < 0.05）; The incidences of constipation at T2 were lower than that at T0（P < 0.001）. Conclusion: Patient self-controlled intrathecal hydromorphone infusion can significantly reduce the cancer pain, improve patients’ quality of life and immune status, and reduce the incidence of constipation.更多还原