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目的观察低浓度多柔比星硬膜外入药治疗癌症椎体转移患者疼痛程度的临床效果。方法选择某院自2008年1月～2011年12月乳腺科治疗的28例乳腺癌合并椎体转移的患者,按照患者的自愿原则,将患者随机分为观察组与对照组,每组14例。观察组术后采用低浓度多柔比星(10～20mg)+甲磺酸罗哌卡因+芬太尼行硬膜外神经阻滞治疗,对照组采用传统的治疗方法吗啡+多柔比星静脉治疗。对两组患者在镇痛效果、用药量、生存质量以及心脏毒性等方面进行比较分析,观察两组的临床效果。结果采用数字分级法(NRS)对两组患者的疼痛程度进行评分,观察组治疗前后NRS评分分别为(6.88±1.66)、(2.41±1.78)分,对照组治疗前后NRS评分分别为(7.01±2.02)、(4.22±1.96)分,两组比较差异有统计学意义(P﹤0.05);观察组患者的生活质量明显提高(t=2.589,P﹤0.05);两组无临床症状的并发症的发生。结论低浓度的多柔比星硬膜外给药,治疗乳腺癌患者癌症椎体转移,其抗癌活性及疗效与传统比较,患者的生存质量明显改善,疼痛程度大大减轻,是一种经济实用、安全有效的方法。
Objective To observe the clinical effects of epidural low-dose doxorubicin in the treatment of cancer pain in patients with vertebral metastases. Methods Twenty-eight cases of breast cancer and vertebral metastasis treated by a breast department in a hospital from January 2008 to December 2011 were selected. According to the patient’s voluntary principle, the patients were randomly divided into observation group and control group, with 14 cases in each group. . The observation group was treated with epidural nerve block with low dose of doxorubicin (10-20 mg) + ropivacaine mesylate + fentanyl postoperatively, and the control group was treated with traditional therapy morphine + doxorubicin. Intravenous treatment. The analgesic effect, dosage, quality of life, and cardiotoxicity were compared between the two groups to observe the clinical effects of the two groups. Results The NRS scores were used to score the pain of the two groups. The NRS scores before and after treatment in the observation group were (6.88±1.66) and (2.41±1.78) points respectively. The NRS scores before and after treatment in the control group were (7.01±). 2.02), (4.22±1.96) points, the difference between the two groups was statistically significant (P<0.05); the quality of life of the observation group patients was significantly improved (t=2.589, P<0.05); two groups had no clinical symptoms of complications happened. Conclusions Epidural administration of low-dose doxorubicin for the treatment of cancer vertebral body metastasis in breast cancer patients, compared with the traditional anti-cancer activity and efficacy, the patient’s quality of life is significantly improved, the pain degree is greatly reduced, is an economical and practical , safe and effective method.