论文部分内容阅读
目的:观察脊髓蛛网膜下腔植入APA-BCC镇痛微胶囊对癌痛病人的镇痛效应及不良反应。方法:将不同剂量的海藻酸钙-聚赖氨酸-海藻酸钙微胶囊包裹的牛肾上腺嗜铬细胞(APA-BCC微胶囊)按常规腰穿的方法注入100例中、重度癌痛患者的腰段脊髓蛛网膜下腔内。按数字分级法(NRS)评定疼痛程度的变化并记录止痛药使用情况;按WHO分级法评价不良反应;按孙燕等指标评价生活质量。结果:(1)APA-BCC注射后0.5~5天,在停用、减量和/或降级使用其它镇痛药的情况下,其镇痛的有效率(CR+PR)为84%、总有效率(CR+PR+MR)为96%,镇痛程度显著优于药物组。(2)1至2次使用后镇痛持续时间为9~220天,明显长于现有镇痛药。(3)APA-BCC治疗后,癌痛病人的生活质量及满意度显著提高。(4)APA-BCC注射后,除部分病人出现与常规蛛网膜下腔注射相近的轻度不良反应外,未观察到严重不良反应,患者的心率、血压、呼吸、肝肾功能、外周血象和免疫功能无明显变化。但单次使用1.5剂量时,2例患者出现了难以耐受的下肢震颤和背部沉重压迫感等重度不良反应。结论:APA-BCC微胶囊植入脑脊液内对癌痛病人具有明确的长效镇痛作用。
Objective: To observe the analgesic effect and adverse reactions of APA-BCC analgesic microcapsules implanted into spinal cord subarachnoid space on patients with cancer pain. Methods: Bovine adrenal chromaffin cells (APA-BCC microcapsules) encapsulated in different dosages of calcium alginate-polylysine-alginate microcapsules were injected into 100 cases of moderate to severe cancer pain patients by conventional lumbar puncture Lumbar spinal cord subarachnoid. According to the grading method (NRS) to assess the change of pain degree and record the use of analgesics; According to the WHO classification method to evaluate the adverse reactions; According to Sun Yan and other indicators to evaluate the quality of life. Results: (1) The effective rate of analgesia (CR + PR) was 84% at the time of APA-BCC 0.5 to 5 days after stopping, decreasing and / or degrading the use of other analgesics The effective rate (CR + PR + MR) was 96%, and the degree of analgesia was significantly better than that of the drug group. (2) The duration of analgesia after 1 to 2 times of use is 9 to 220 days, which is obviously longer than the existing analgesics. (3) The quality of life and satisfaction of cancer pain patients increased significantly after APA-BCC treatment. (4) After APA-BCC injection, no serious adverse reactions were observed in some patients, except mild adverse reactions similar to conventional subarachnoid injections. The patients’ heart rate, blood pressure, respiration, liver and kidney function, peripheral blood and No significant changes in immune function. However, with a single dose of 1.5, two patients developed severe adverse reactions such as unpleasant lower extremity tremor and heavy back pressure. Conclusion: The APA-BCC microcapsules implanted into cerebrospinal fluid have a definite long-term analgesic effect on cancer pain patients.