慢性顽固疼痛患者芬太尼透皮贴剂的门诊治疗  

Transdermal Fentanyl Treatment in Ambulatory Clinic for Patients with Chronic and Stubborn Pain

作　　者：房文学[1] 杜敏逸[1] 许幸[1] 吴新民[1] 

机构地区：[1]北京大学第一医院麻醉科,北京市100034

出　　处：《中国肿瘤临床》2006年第9期494-496,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:观察门诊慢性疼痛患者用芬太尼透皮贴剂(Transdermalfentanyl,TDF)的镇痛疗效。方法:选择慢性顽固性疼痛患者416例,其中中、晚期癌症性疼痛占314例,非癌性疼痛102例,使用TDF止痛。对治疗前后的疼痛强度、生活质量评价及用药中的不良反应,进行观察和统计分析。结果:癌性疼痛治疗前疼痛视觉模拟评分(VAS)为7.94±1.15,治疗后降低至1.64±1.71;非癌性疼痛治疗前为7.30±1.54,治疗后降低至1.91±1.53。癌性疼痛的明显缓解率为51.5%,完全缓解为19.7%,总缓解率71.2%。非癌性疼痛明显缓解率为45.0%,完全缓解13.7%,总缓解率58.7%。生活质量治疗前后均变化(P<0.01)。用药的不良反应与传统的阿片类药物相似,为便秘、恶心、呕吐、头晕等症,但程度较轻;未出现呼吸抑制者。治疗后需停药的患者无身体及精神戒断症状发生。结论:TDF具有无创性、不间断的给药途径,镇痛效果确实,不良反应发生率低,患者依从性好,适合门诊、家庭应用。Objective： To observe the analgesic efficacy of Transdermal fentanyl （TDF） in patients with chronic and stubborn pain. Methods： Four-hundred and sixteen cases of the ambulatory clinic were enrolled in this study on treatment with TDF, of which 314 were suffering from medial or late cancer pain and 102 were of non-cancerous pain. The intensity of pain （measured by visual analogue scale, VAS）, quality of life, side effect of TDF before and after treatment were observed and compared. Results： VAS decreased significantly from 7.94±1.15 to 1.64±1.71 after treatment in patients with cancerous-pain, and from 7.30±1.54 to 1.91 ±1.53 in non-cancer patient. In cancer patients, 51.5% was markedly relieved from pain, of 19.7% was free from pain, and total relief rate accounted for 71.2%. In non-cancer patients reached 45%, 13.7%, and 58.7% respectively. The quality of life in both patients improved significantly （P〈0.01）. The side-effect of TDF was similar to other opiates： mainly dizziness, nausea and vomiting, but they were mild. No occurrence of respiratory depression, physical or mind dependence after stopping treatment. Conclusion： TDF possesses characteristics of noninvasive route of administration, continued release of the drug, valid analgesic effect, mild side-effect, good compliance of patients and is suitable for application in out-patients clinic or family.

关 键 词：芬太尼透皮贴剂 慢性疼痛 癌症性疼痛 非癌性疼痛 

分 类 号：R402[医药卫生—临床医学]