44例晚期癌痛患者口服吗啡转换为芬太尼贴剂的疗效分析  

ANALGESIC EFFECTS OF TRANSDERMAL FENTANYL ON 44 PATIANTS WITH CANCER PAIN SWITCHING FROM ORAL MORPHINE

作　　者：邵月娟[1] 王昆[1] 成宪江[1] 穆怀焕[1] 

机构地区：[1]天津医科大学附属肿瘤医院疼痛科,天津市"肿瘤防治"重点实验室,天津300060

出　　处：《中国疼痛医学杂志》2008年第6期335-337,共3页Chinese Journal of Pain Medicine

摘　　要：目的:评价晚期癌痛患者由口服吗啡转换应用芬太尼透皮贴剂止痛的疗效与不良反应。方法:44例口服吗啡镇痛不满意的晚期癌痛患者,换用芬太尼透皮贴剂止痛,吗啡与芬太尼贴剂的剂量换算比为100:1。采用0～10数字疼痛强度评分法评价疼痛强度,评分降低≥2表示疼痛缓解有临床显著性差异;不良反应评估分为4级:无不良反应(0)、轻度(1)、中度(2)或重度(3)。结果:药物转换后疼痛强度明显降低,转换前平均疼痛评分为6.1,转换后7天降至3.5,32例(72.7%)患者疼痛缓解有临床显著性差异。发生至少一种不良反应的患者转换前为34例(77%),转换后降至21例(48%),分别有60%及43%的患者恶心呕吐和便秘症状得到缓解。结论:口服吗啡镇痛不满意的晚期癌痛患者转换应用芬太尼贴剂后镇痛效果提高,胃肠道症状改善。Objective： To evaluate the analgesic and side ral morphine on patients with cancer pain. Methods： 44 effects of transdermal tentanyl switching trom opatients with cancer pain who failed to achieve adequate pain control were converted from oral morphine to transdermal fentanyl. A dose ratio with oral morphine/transdermal fentanyl of 100 ： 1 （mg） daily was calculated. Pain intensity was rated by numerial rating scale （NRS）. Clinically obvious pain control was defined as a decrease ≥ 2 points in pain intensity. The presence of side effects was evaluated as absent （0） , mild （ 1 ） , moderate （ 2 ） or severe （ 3 ）. Results： Pain intensity decreased significantly after switching. The mean pain score decreased from 6.1 to 3.5 on 7 day after switching. Clinically obvious pain control was seen in 32 patients （72.7%）. One or more side effects occurred in 34（77% ） patients before switching and in 21 （48%） patients after switching. The nausea or vomiting was relieved in 60% of patients and constipation was relieved in 43% of patients. Conclusion： Transdermal fentanyl may be effective in pain and gastrointestinal symptoms for cancer patients who failed to control pain with oral morphine.

关 键 词：芬太尼透皮贴剂 晚期癌痛 阿片转换 吗啡 

分 类 号：R730.5[医药卫生—肿瘤] R614.42[医药卫生—临床医学]