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目的探讨宫颈癌腔内和组织间插植三维近距离放疗中简便、安全的疼痛管理方法。方法选择2015年11月—2016年1月在河南省肿瘤医院接受腔内和组织间插植三维后装近距离放疗患者10位,每周1次,共进行治疗30次,其中盐酸吗啡针皮下注射联合丁卡因胶浆阴道表面涂抹20次,吗啡针联合阴部神经组织麻醉10次。疼痛评定采用数字评分法VAS。结果 10位患者30次治疗中,0分无痛5次,1~3分轻微疼痛20次,占83.3%,4~6分中度疼痛5次,占16.7%。联合神经阻滞麻醉行外阴插植6次,评分均为0。30次治疗中,患者均表示疼痛可以耐受,可以轻松配合治疗。结论盐酸吗啡针皮下注射联合阴部神经阻滞麻醉和丁卡因胶浆阴道粘膜表面涂抹的止痛处理安全有效,可以满足宫颈癌腔内和组织间插植三维近距离放射治疗的需要。
Objective To investigate the simple and safe method of pain management in cervical intraepithelial neoplasia and interstitial implantation of three-dimensional brachytherapy. METHODS: From November 2015 to January 2016, 10 patients who underwent brachytherapy with three-dimensional posterior brachytherapy were treated in Henan Tumor Hospital for 30 times a week for 30 times. Morphine hydrochloride was administered subcutaneously Combined injection of tetracaine gel vaginal surface smear 20 times, morphine needle combined vaginal nerve tissue anesthesia 10 times. Pain assessment using digital scoring VAS. Results Ten patients had painlessness five times during 30 times of treatment, minor pain from 1 to 3 20 times, accounting for 83.3%, moderate pain from 4 to 6, accounting for 16.7%. Joint nerve block anesthesia Vulvar implants 6 times, the score was 0.30 times in the treatment, the patients said the pain can be tolerated, you can easily cooperate with the treatment. Conclusion The analgesic treatment of subcutaneous injection of morphine hydrochloride injection together with pudendal nerve block anesthesia and vaginal mucosa smear of tetracaine glue is safe and effective, which can meet the need of three-dimensional brachytherapy of cervical intraepithelial neoplasms and interstitial implants.