摘要
目的 探讨老年癌症疼痛病人接受芬太尼透皮贴剂治疗的止痛疗效及安全性。方法全国 2 3个省自治区、直辖市 136家医院共 16 6 4例 ,年龄≥ 6 5岁的老年癌痛病人接受了芬太尼透皮贴剂的止痛治疗 ,平均年龄 72 6岁 (6 5～ 90岁 )。芬太尼透皮贴剂的初始、15d和 30d用药剂量均值分别为 31 34μg/h ,4 0 5 9μg/h和 4 7 5 0 μg/h (2 5～ 2 0 0 μg/h)。 结果 治疗前疼痛程度评分 x为7 34。治疗 1d、3d、6d、9d、15d、30d疼痛程度评分均值分别降低至 3 82 ,2 80 ,2 4 3,2 11,1 83,1 79(P <0 0 1) ,总有效率 97 18%。治疗前 2 5 4 %的病人生活质量良好 ,治疗后 15d和 30d ,71 15 %和 73 0 4 %病人生活质量良好 (P <0 0 1)。不良反应 :便秘为 10 70 % ,恶心为 11 96 % ,头晕为 6 85 % ,呕吐为 3 85 % ,嗜睡为 2 4 0 % ,呼吸抑制为 0 12 %。 86 2 %病人选择继续用芬太尼透皮贴剂。结论 芬太尼透皮贴剂治疗老年癌痛病人安全有效 ,病人满意度高。推荐老年病人的初始剂量为 2 5 μg/h。
Objective To evaluate the effects and side effects of transdermal fentanyl for the elderly patients with cancer pain. Methods A multicenter clinical test was conducted among 1 664 patients with cancer pain, aged 65～90 with a median age of 71, 879 (52.8%) of which used opioid for the first time, from 136 hospitals in 23 provinces in China. All patients received transdermal fentanyl to treat cancer pain with the mean dose of fentanyl of 31.34 μg/h (25～150 μg/h) initially, and 40.59 μg/h and 47.50 μg/h (25～200 μg/h) at day 15 and day 30. They were asked to record the attacks of pain, quality of life, and any side effects of the treatment. Results The baseline pain intensity score was 7.34. On days 1, 3, 6, 9 15, and 30, the mean pain scores were decreased to 3.82, 2.80, 2.43, 2.11, 1.83, and 1.64 (all P<0.01) respectively. The effective rate was 97.18%. The fine life quality rate was 25.4% before treatment, and was 71.15% and 73.04% at day 15 and day 30 (both P<0.01). The commonest side effects included constipation (10.70%), nausea (11.96%), dizziness (6.85%), vomiting (3.85%), sleepiness (2.40%), and respiratory depression (0.12%). The incidence of constipation was related with age, the incidence of vomiting and difficulty of urination was related with gender. 86.2% patients preferred to receive transdermal fentanyl. Conclusion Safe, convenient, and capable to improve the quality of life, transdermal fentanyl is effective and worth recommending as a first-line drug for the treatment of elderly patients with moderate to severe cancer pain. The initial dose is recommended as 25 μg/h.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2003年第22期1931-1935,共5页
National Medical Journal of China
