Mezawa Hidetoshi, Inoue Daisuke, Nagasaki Eijiro, Kobayashi Tadashi, Sakuyama Toshikazu, Aba Keisuke
Dept. of Oncology and Hematology, The Jikei University Hospital, School of Medicine.
Gan To Kagaku Ryoho. 2008 Dec;35 Suppl 1:22-4.
When an effective pain relief cannot be achieved by systemic administration of analgesics, which provide adequate pain relief for up to 70 to 90 percent of patients, alternative remedies should be offered. We reported a patient with colon cancer who was effective for pain control using an epidural catheter with subcutaneous reservoir (epidural subcutaneous catheter implantation). Four other patients with an epidural catheter with subcutaneous reservoir during 2007 to 2008 also showed significant improvement in their pain level calculating by numerical rating scale (NRS). Furthermore we were able to minimize the risk of infection for homecare. However the epidural catheter with subcutaneous reservoir should be needed not only to manage dosages of epidural morphine accurately but also to prevent the incidence of catheter obstruction by general practitioners in home care service. This solution is necessary to establish the common strict guidelines between hospital doctors and general practitioners.
当通过全身给药使用镇痛药无法实现有效止痛时（这些镇痛药能为多达70%至90%的患者提供充分的疼痛缓解），应提供替代疗法。我们报告了一名结肠癌患者，其使用带皮下储液器的硬膜外导管（硬膜外皮下导管植入）控制疼痛有效。在2007年至2008年期间，另外四名使用带皮下储液器硬膜外导管的患者通过数字评分量表（NRS）计算，其疼痛水平也有显著改善。此外，我们能够将家庭护理中的感染风险降至最低。然而，带皮下储液器的硬膜外导管不仅需要由家庭护理服务中的全科医生准确管理硬膜外吗啡的剂量，还需要防止导管阻塞的发生。这种解决方案对于在医院医生和全科医生之间建立共同严格的指导方针是必要的。
