癌痛患者经盐酸羟考酮缓释片治疗后发生戒断反应的5例临床病例分析  

Clinical Analysis on Opioid Withdrawal of Five Patients with Cancer Pain after Stopping Oral Oxycodone Hydrochloride Sustained-release Tablets

作　　者：王颖怡 刘小林[3,2] 朱秋燕[4,2] 谢瑞杰[5,2] 符一岚 

机构地区：[1]重庆市璧山区人民医院,重庆璧山402760 [2]湖南省肿瘤医院/中南大学湘雅医学院附属肿瘤医院,湖南长沙410013 [3]江苏省肿瘤医院,江苏南京210009 [4]南通大学附属医院,江苏南通226021 [5]柳州市人民医院,广西柳州545006

出　　处：《肿瘤药学》2017年第1期119-123,共5页Anti-Tumor Pharmacy

摘　　要：目的探讨癌痛患者口服盐酸羟考酮缓释片治疗后发生戒断反应的原因和治疗方法。方法收集湖南省肿瘤医院2015年11月~2016年9月收治的住院癌痛患者,统计经盐酸羟考酮缓释片治疗后出现戒断症状的人数,对收集的5例患者临床治疗特点、出现戒断症状的原因、治疗方法及预后进行分析。结果 1例患者出现心悸、兴奋、失眠、多汗、烦躁不安,经氨酚羟考酮片减量治疗后完全缓解;1例出现心悸、兴奋、失眠、多汗、烦躁不安、流泪,经盐酸羟考酮缓释片减量治疗后完全缓解;1例夜间出现心悸、兴奋、失眠、多汗,对症治疗后完全缓解,2例出现心悸、兴奋、失眠、多汗、烦躁不安,经氨酚羟考酮片治疗2天,继续对症治疗后完全缓解。结论癌痛患者发生戒断反应的原因可能与患者自我评估疼痛控制可,自行调整用药导致血药浓度不稳定有关,阿片类药物减量疗法对此有一定效果。Objective To study the factors and treatment measurements of opioid withdrawal induced by stopping Oral Oxycodone Hydrochloride Prolonged-release Tablets. Methods Patients with cancer pain from November 2015 to September 2016 in Hunan Cancer Hospital were collected. Collect the data of patients with opioid withdrawal after stopping oral Oxycodone Hydrochlofide Prolonged-release Tablets. A total of five patients were included, and their clinical characteristics, reasons, treatments and prognosis of opioid withdrawal were analyzed. Results Of the five patients, one patient with palpitation, excitation, insomnia, sweating, irritability was completely eased by gradual reduction of Oxycodone Acetaminophen dose. One patient with palpitation, excitation, insomnia, sweating, irritability and tears was completely eased by gradual reduction of Oxycodone Hydrochloride Prolonged-release Tablets dose. Another patient with palpitation, excitation, insomnia, sweating at night was completely eased by symptomatic treatment. And other two patients with palpitation, excitation, insomnia, sweating and irritability was completely eased by oxycodone and acetaminophen tablets for two days combined with symptomatic treatment. Conclusion The reasons of patients＇ opioid withdrawal with cancer pain may relate to the unstability of blood concentration due to the adjusted medication by themselves according to their own assessment of pain control. Gradual reduction of opioid is effective to the opioid withdrawal.

关 键 词：癌痛 盐酸羟考酮缓释片 戒断反应 

分 类 号：R969[医药卫生—药理学]