鞘内吗啡输注系统治疗晚期癌痛的镇痛效果与护理对策

安苏芳　林宪法

[摘要] 目的 分析鞘內吗啡注射系统治疗晚期癌痛的镇痛效果与护理对策。 方法 选取2015年1月～2016年12月我院收治的100例晚期癌症患者，随机分为观察组与对照组。两组患者均采用鞘内吗啡注射系统治疗，对照组采取常规护理模式，观察组在对照组的基础上加入疼痛护理。比较两组患者的镇痛效果、护理依从性及家属对护理的满意度，并使用焦虑自评量表（SAS评分）和抑郁自评量表（SDS评分）观察两组患者护理前后心理状况变化。结果 观察组患者的镇痛效果略高于对照组，但两组间差异无统计学意义。观察组护理依从性及护理满意率均显著优于对照组，两组间比较差异有统计学意义（P<0.05）。观察组护理前后SAS评分、SDS评分比较差异有统计学意义（P<0.05），而对照组护理前后SAS评分、SDS评分比较差异无统计学意义。 结论 鞘内吗啡输注有助于缓解晚期癌症患者的疼痛症状，通过疼痛护理干预有助于提高患者对临床护理的依从性，缓解晚期癌症患者的疼痛症状和焦虑、抑郁情绪，从而提升患者和家属对护理服务的满意率。

[关键词] 鞘内吗啡输注；晚期癌症；镇痛效果；护理效果

[中图分类号] R473.73 [文献标识码] B [文章编号] 1673-9701（2017）14-0152-04

[Abstract] Objective To analyze the analgesic effect and nursing strategy of intrathecal morphine infusion system in the treatment of advanced cancer pain. Methods 100 patients with advanced cancer who were admitted to our hospital from January 2015 to December 2016 were selected and were randomly divided into the observation group and the control group. Two groups of patients were given intrathecal morphine injection system. The control group was given routine nursing mode， and the observation group was given pain care on the basis of the control group. The analgesic effect， nursing compliance and the families satisfaction degree towards nursing care were compared between the two groups of patients. The self-rating anxiety scale（SAS score） and self-rating depression scale（SDS score） were used to observe the changes of psychological status before and after nursing in both groups. Results The analgesic effect in the observation group was slightly higher than that in the control group， but there was no statistically significant difference between the two groups； the nursing compliance and nursing satisfaction rate in the observation group were significantly better than those in the control group， and the difference between the two groups was statistically significant（P<0.05）； there were statistically significant differences in SAS scores and SDS scores before and after nursing in the observation group（P<0.05）， and there was no statistically significant difference in SAS score and SDS score before and after nursing in the control group. Conclusion Intrathecal morphine infusion is conducive to relieving the pain symptoms in the patients with advanced cancer； pain nursing intervention helps to improve patients' compliance with clinical care， relieve pain symptoms and anxiety and depression in the patients with advanced cancer， and thereby increasing the satisfaction rate of patients and family towards nursing care.

[Key words] Intrathecal morphine infusion； Advanced cancer； Analgesic effect； Nursing effect

相关研究指出，晚期癌症患者多伴随着剧烈疼痛，影响患者的生活质量[1，2]。目前临床中多使用镇痛药物缓解癌症患者的疼痛，但是口服用药对药量的要求较高，容易引发各种不良反应。因此需要寻找其他用药途径减轻不良反应的发生率。因此，文章主要针对鞘内吗啡注射系统治疗晚期癌痛的镇痛效果与护理对策展开分析，现报道如下。

1 资料与方法

1.1 临床资料

选取2015年1月～2016年12月我院收治的100例晚期癌症患者，随机分为观察组与对照组。观察组男26例，女24例；年龄51～72岁，平均（60.5±9.5）岁；其中肝癌15例、肺癌22例、胃癌10例、乳腺癌3例。对照组男27例，女23例；年龄50～73岁，平均（61.3±8.5）岁，其中肝癌15例、肺癌20例、胃癌10例、乳腺癌5例。……