镇痛泵在肝癌介入治疗中应用.docVIP

镇痛泵在肝癌介入治疗中应用 　【摘要】 目的：评价自控镇痛泵缓解肝癌患者接受肝动脉栓塞化疗时腹部疼痛的效果。方法：住院行介入治疗的38例肝癌患者，男性30例，女性8例，年龄38岁～73岁，平均年龄56.12岁，所有病例均行影像（超声、CT或MRI等）、实验室（AFP等）检查，临床综合诊断为肝癌，其中10例穿刺活检病理证实为肝癌。患者第一次肝动脉栓塞化疗采用常规止痛方法，第二次使用镇痛泵，比较两种方法止痛效果。结果：使用常规止痛方法患者均有明显腹部疼痛，而使用镇痛泵后，所有患者都没有明显的腹痛症状。结论：镇痛泵在肝癌介入治疗时镇痛效果优越，值得使用。 【关键词】 肝癌；自控镇痛泵；肝动脉栓塞化疗 　　Application of Patientscontrolledanalgesia in Patients with Hepatocellular Carcinoma Treating by Transcatheter Arterial Chemoembolization 　　ZHOU Liang, CHEN Huiyu 　　The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China 　　Abstract: Objective To explore the effects of patientscontrolledanalgesia (PCA) on alleviating abdominal pain of patients with hepatocellular carcinoma by transcatheter arterial chemoembolization (TACE). Methods Thirtyeight patients with hepatocellular carcinoma (30 male and 8 female) treated with TACE (age 38～73 years, average age 56.12 years). All cases were patients diagnosed with imaging examination (e.g. transonogram, CT and MRI) and laboratory examination (e.g. AFP), and 10 of 38 patients were diagnosed with histopathologically confirmed hepatocellular carcinoma by hepatic biopsy. The first treatment of these patients was treated with conventional analgesia during TACE, and the second was treated with PCA. The effects of analgesia were evaluated between these two different treatments. Results The all patients treated with conventional analgesia treatment felt violent pain, however, when they treated with PCA, no patient was found with violent pain. Conclusion Administration of patientscontrolledanalgesia in patients with hepatocellular carcinoma by transcatheter arterial chemoembolization can dramatically remit pain compared with conventional analgesia. 　　Key words: Hepatocellular carcinoma; Patientscontrolledanalgesia; Transcatheter arterial chemoembolization 原发性肝细胞肝癌（hepatocellular carcinoma, HCC）是我国高发病率的恶性肿瘤之一，由于本病早期无典型症状，发现困难，患者到医院就医明确诊断时多为中、晚期，已失去手术切除的最佳时机，其自然生存期只有3个月～6个月。对于不能手术的中、晚期肝癌患者