癌痛患者疼痛门诊药物治疗的临床效果分析  

Clinical analysis of standardized drug treatment of cancer pain at the pain clinic

作　　者：史鹤玲[1] 李雪冰[1] 张同梅[1] 胡范彬[1] 吕嘉林[2] 孟弃逸[3] 李宝兰[1] 

机构地区：[1]首都医科大学附属北京胸科医院综合科,北京市101149 [2]首都医科大学附属北京胸科医院肿瘤二科,北京市101149 [3]首都医科大学附属北京胸科医院肿瘤一科,北京市101149

出　　处：《中国肿瘤临床》2013年第24期1506-1508,共3页Chinese Journal of Clinical Oncology

摘　　要：目的：探讨癌痛规范化治疗中癌痛患者疼痛门诊镇痛药物治疗效果及不良反应的临床分析。方法：对2012年4月至2013年4月首都医科大学附属北京胸科医院疼痛门诊癌痛患者诊治情况每月汇总，分析引起癌痛的疾病种类，癌痛原因、分类、程度，药物治疗种类，疗效及不良反应等。结果：疼痛门诊收治患者787例。镇痛药物用药途径以口服为主680例（86.4%）。使用单一药物盐酸羟考酮缓释片430例（54.6%），日剂量20～90 mg/d为疼痛控制。632例（80.3%）患者以阿片类药物单一治疗为主，少数患者联合2～3种药物治疗。规范治疗后与治疗前比较中重度疼痛患者比较明显减少（31.5%vs.55.5%），无痛患者增多。不良反应方面，254例（32.3%）患者使用阿片类药物易引起便秘，轻度恶心呕吐、头晕、嗜睡、食欲减退、尿潴留、口干、腹胀、幻觉症状均可耐受，少数患者需干预处理预防或对症治疗。结论：在医院创建癌痛规范化治疗示范项目中疼痛门诊作用不容忽视，规范管理意义重大。疼痛门诊的设立使癌痛规范化治疗成为示范病房的延续。Objective： To observe the efficacy and safety of analgesic drugs in the standardized treatment of cancer pain patients at the pain clinic. Methods： The data of 787 cancer pain patients and their corresponding prescriptions for cancer pain were collected from April, 2012 to April, 2013 at the pain clinic. The obtained information comprise of diseases that lead to cancer pain, cause of pain, pain intensity, and efficacy and side effects of medications. Diseases that caused cancer pain include 658 cases with primary malignant lung cancer. Results： Pain was mainly caused by primary lung cancer in 787 cancer-related patients. An analgesic drug, namely, oxycodone hydrochloride, was administered in 54.6% via single drug therapy. The daily dosage range of this drug was 20 to 90 mg/d in 280 cases. About 35.6% of the studied patients with a daily dosage of 90 mg/d or lower had their pain effectively managed. After the treatment, the number of cases with moderate to severe pain was reduced from 437 （55.5%） to 248 （31.5%）. The oral administration of opioid oxycodone hydrochloride tablets ranked first among the prescribed drugs for cancer pain, and single-drug therapy was the choice of medication. The majority of patients had satisfactory pain-relief with a daily dosage of less than 90 mg/d upon the administration of oxycodone hydrochloride sustained-release tablets and morphine sulfate controlled-release tablets. Side effects included mild constipation, nausea, vomiting, dizziness, loss of appetite, urinary retention, somnolence, and so on. Intervention treatment was needed in most of the patients. Conclusion： Pain clinic is critical in the administration of standardized treatment for cancer pain in hospitals. The establishment of pain clinic ensures the standardized treatment of cancer pain.

关 键 词：癌痛 癌痛规范化治疗示范病房 疼痛治疗 疼痛门诊 

分 类 号：R730.5[医药卫生—肿瘤]