摘要
目的观察静脉吗啡滴定治疗中重度癌痛的疗效及不良反应。方法选取13例中重度癌痛住院患者进行静脉吗啡滴定,每15分钟通过疼痛数字分级法(NRS)评价患者疼痛变化程度,记录和处理其不良反应,调整静脉用药剂量,24 h后统计静脉吗啡累计剂量,通过与控缓释剂阿片类镇痛药物的剂量转换,改用口服剂型或透皮剂维持镇痛。结果在所有静脉吗啡滴定患者中,在0～3 h内疼痛NRS评分皆下降,3～6 h内NRS评分至少下降3分,24 h镇痛有效率为100%;在毒副作用的观察方面,24 h内发生急性呼吸抑制1例,1～2度急性呕吐5例,3度呕吐1例,头晕8例,经及时治疗后症状好转。结论对于中重度癌痛患者,相比于口服速效类阿片类药物或奥施康定等滴定镇痛,静脉吗啡滴定具有起效快、镇痛效果肯定等特点,对于住院的中重度癌痛患者,应用静脉吗啡滴定安全,毒副作用可控,值得进一步推广应用。
Objective To observe the effectiveness and adverse reaction of intravenous morphine titration treatment for moderate to severe pain with. Methods In this study, 13 hospitalized patients with moderate or severe pain are treated with intravenous morphine titration,evaluating pain patients variations through Numerical Rating Scales （NRS） every 15 min- utes, recording and processing the adverse reactions, and adjusting dose, calculating the cumulative dose of morphine Cal- culate 24 hours later,oral or transmucosal conversion to control pain. Results All patients＇NRS scores are reduced in 0-3 hours,NRS score at least reduce three points in 3-6 hours, the pain relief rate was 100% in 24 hours;the commn toxici- ties were acute respiratory inhibition（1/13）, 1-2 degrees acute vomiting（5/13）,3 degrees vomiting（1/13） and dizzy（8/13）. With timely treatment, all these symptoms are under controlled. Conclusion For the patients with moderate to severe pain, compared to the oral opioid to titration analgesia, intravenous morphine titration work faster,has satisfied results.For the hospitalized patients with moderate to severe pain, the application of intravenous morphine is safe, and the side effects are under controlled.So it is worth for further promotion and application.
出处
《中国现代医生》
2012年第27期82-84,共3页
China Modern Doctor
关键词
硫酸吗啡针
静脉滴定
癌痛
Sulfuric acid morphine injection
Intravenous morphine titration
Cancer pain
