Kinoshita Shoji, Inoue Daisuke, Sakuyama Toshikazu, Yoshizawa Akitaka, Nagasaki Eijiroh, Arakawa Yasuhiro, Uwagawa Tadashi, Kobayashi Kazuma, Kobayashi Tadashi, Saitoh Nobuhiro, Aiba Keisuke
The Jikei University Daisan Hospital.
Gan To Kagaku Ryoho. 2012 Dec;39 Suppl 1:61-3.
We report the case of a patient with a stage IV b pancreatic cancer in which epidural/subcutaneous reservoir therapy was effective for pain control. However, a catheter-related infection caused by methicillin-resistant Staphylococcus aureus (MRSA)was occurred. In recent years, the number of cancer patients desiring palliative home-based care in Japan has increased. Epidural/subcutaneous reservoir therapy is often offered to relieve refractory pain, and to reduce the side effects of systemic administration of opioids, such as drowsiness, in homecare patients. We believe that this patient may have been able to continue home-based care if the catheter-related infection did not occur, because a significant improvement was calculated in the pain level by the numerical rating scale(NRS)observed. It is important to establish and share common strict guidelines between hospital doctors and general practitioners for the management of the subcutaneous catheter and reservoir therapy in order to prevent catheter-related infections over a long period.
我们报告了一例IV b期胰腺癌患者，其硬膜外/皮下贮器疗法对疼痛控制有效。然而，发生了由耐甲氧西林金黄色葡萄球菌（MRSA）引起的导管相关感染。近年来，日本希望接受姑息性居家护理的癌症患者数量有所增加。硬膜外/皮下贮器疗法常用于缓解难治性疼痛，并减少居家护理患者中阿片类药物全身给药的副作用，如嗜睡。我们认为，如果没有发生导管相关感染，该患者可能能够继续居家护理，因为通过数字评分量表（NRS）观察到疼痛水平有显著改善。为了长期预防导管相关感染，医院医生和全科医生之间建立并共享关于皮下导管和贮器疗法管理的共同严格指南非常重要。
