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| 1 | 小剂量氯胺酮联合罗哌卡因、芬太尼硬膜外自控镇痛在顽固性晚期癌痛患者中的止痛效果观察显示文摘目的观察小剂量氯胺酮联合罗哌卡因、芬太尼硬膜外自控镇痛(PCEA)在顽固性晚期癌痛患者中的止痛效果。方法将选择的35例晚期癌痛患者随机分为A组17例和B组18例。A组镇痛泵药液组成:0.894%甲磺酸罗哌卡因40ml,芬太尼0.2mg,氟哌利多5mg加生理盐水至200ml。B组在A组基础上加氯胺酮200mg后加生理盐水至200ml。分别在安装止痛泵后24h、48h、5d、7d采用疼痛视觉模拟评分(VAS)评估疼痛程度,统计48h内PCA按压次数、芬太尼用量及患者恶心、呕吐、嗜睡以及呼吸抑制等镇痛相关并发症发生情况。结果治疗前2组患者VAS评分差异无统计学意义(P>0.05)。治疗后,2组疼痛均明显缓解。A组治疗后24h、48h、治疗后5d VAS评分均低于治疗前,差异有统计学意义(P<0.05),治疗7d VAS评分与治疗前比较差异无统计学意义(P>0.05);B组治疗后各时间点与治疗前比较VAS差异均有显著性(P<0.05)。组间比较:B组治疗后在24h、48h、治疗5d的VAS评分与A组同时点比较差异均无统计学意义(P>0.05),治疗7d VAS评分低于A组,差异有统计学意义(P<0.05)。A组PCA按压次数和芬太尼用量明显多于B组,差异有统计学意义(P<0.05)。A组患者恶心、呕吐、嗜睡以及呼吸抑制等镇痛相关并发症发生率为94.1%(16/17)明显高于B组的11.1%(2/18),差异有统计学意义(P<0.05)。结论经硬膜外小剂量氯胺酮联合罗哌卡因、芬太尼自控镇痛具有镇痛作用强、不良反应小等优点,适合中、重度晚期顽固性癌痛患者的止痛。 | 高秀泽 | 2016 | 临床合理用药杂志2016，9，7： | 3 |
| 2 | Road map for pain management in pancreatic cancer: A review显示文摘Beside its poor prognosis and its late diagnosis, pancreatic cancer remains one of the most painful malignancies. Optimal management of pain in this cancer represents a real challenge for the oncologist whose objective is to ensure a better quality of life to his patients. We aimed in this paper to review all the treatment modalities incriminated in the management of pain in pancreatic cancer going from painkillers, chemotherapy, radiation therapy and interventional techniques to agents under investigation and alternative medicine. Although specific guidelines and recommendations for pain management in pancreatic cancer are still absent, we present all the possible pain treatments, with a progression from medical multimodal treatment to radiotherapy and chemotherapy then interventional techniques in case of resistance. In addition, alternative methods such as acupuncture and hypnosis can be added at any stage and seems to contribute to pain relief. | Marie José Lahoud Hampig Raphael Kourie Joelle Antoun Lana El Osta Marwan Ghosn | 2016 | World Journal of Gastrointestinal Oncology2016，8，8： | 0 |
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