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晚期癌症病人难以忍受的剧烈疼痛,是临床医学亟待解决的社会问题。作者近年收治了8例晚期癌症疼痛病人,这些癌症病人都是因失去手术时机或手术后癌细胞广泛转移正在接受放化疗治疗。根据病人疼痛最剧烈的部位选择穿刺点行硬膜外穿刺置管,用吗啡2mg,075%面吡卡因4ml,1/200000肾上腺素加生理盐水稀释至10ml注入硬膜外腔,无菌保护硬膜外导管。以后每12~48小时按上述量加药。镇痛效果满意,镇痛时间平均可达12~48小时,治疗时间最长72天,最短5天,未发生一例意外,深受病人欢迎。本文从病例及穿刺点选择,药物配方,给药方法,无菌保护导管等方面详尽说明,该法在临床应用上是安全的,可靠的,值得借鉴和推广。
The unbearable severe pain in patients with advanced cancer is a social problem to be solved in clinical medicine. In recent years, the author has treated 8 patients with advanced cancer pain. These cancer patients are undergoing radiotherapy and chemotherapy due to the loss of surgical time or extensive metastasis after surgery. According to the patient’s most painful site, the puncture site was selected for epidural puncture and placed in the epidural space with morphine 2 mg, 0 75% pebucaine 4 ml, 1/200000 adrenaline and normal saline diluted to 10 ml. Bacterial protection epidural catheter. After every 12 to 48 hours, dosing according to the above amount. The analgesic effect was satisfactory. The analgesic time averaged 12 to 48 hours. The treatment lasted for 72 days and the shortest 5 days. No accidents occurred and it was well received by the patients. This article elaborates on the selection of cases and puncture points, drug formulations, drug delivery methods, catheters for sterilizing protection, etc. This method is safe and reliable in clinical application and worthy of reference and promotion.