基层医院老年癌症患者三阶梯止痛治疗156例分析  

Analysis of 156 elderly patients with cancer treated with three-step analgesic treatment in grassroot hospital

作　　者：黎明 韩坤[2] 

机构地区：[1]上海市黄浦区顺昌医院,上海200023 [2]上海交通大学附属第六人民医院东院,上海201306

出　　处：《上海医药》2017年第12期24-26,共3页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:观察基层医院老年癌痛患者三阶梯止痛治疗的效果与不良反应,为基层医院普及癌痛三阶梯治疗提供可靠依据。方法:选择2012年3月—2016年10月老年癌痛患者156例,按癌痛三阶梯治疗原则给予止痛治疗,轻度疼痛者给予塞来昔布胶囊20 mg/12 h,睡前加或不加地西泮口服,中度疼痛者在轻度疼痛给药基础上加用盐酸曲马多缓释片100 mg/12 h,重度疼痛者在轻度疼痛给药基础上加用吗啡10 mg/4 h滴定,直至患者无痛后,按照阿片类药物剂量转换原则,给予硫酸吗啡控释片或多瑞吉透皮贴剂。结果:156例患者中,150例止痛有效,总有效率为96%,其中轻度疼痛止痛有效为5/5,中度疼痛为98%(49/50),重度疼痛为95%(96/101)。不良反应均较轻,其中便秘42例,恶心呕吐16例,头晕6例,尿潴留2例,嗜睡3例,无精神依赖患者出现。结论:三阶梯止痛法安全有效,应在基层医院老年癌痛患者止痛治疗中大力推广。Objective： To observe the effect and adverse reactions of three-step analgesic treatment in the elderly patients with cancer pain in grassroot hospital to provide a reliable basis for the cancer pain three-step analgesic treatment. Methods： From March 2012 to October 2016, 156 cases of elderly cancer pain were selected and according to the principle of three-step analgesic treatment of cancer pain to give the treatment of pain, mild pain was given celecoxib capsules 20 mg / 12 h, and before going to bed oral administration of diazepam was added or not added. On the basis of mild pain administration, moderate pain was added to tramadol hydrochloride sustained release tablets 100 mg/12 h, and severe pain was added with morphine 10 rag/4 h titration, and until the patient painless, in accordance with the opioid dose conversion principle, morphine sulfate controlled- release tablets or durogesic transdermal patch were given. Results： Of the 156 patients, 150 cases were effective in pain relief and the total effective rate was 96%, among them, analgesic effects of mild pain, moderate pain and severe pain were 5/5, 98%（49/50） and 95%（96/101）. Adverse reactions were mild, including constipation in 42 cases, nausea and vomiting in 16 cases, dizziness in 6 cases, urinary retention in 2 cases and lethargy in 3 cases, and no patients with mental dependence. Conclusion： Three - step analgesic method is safe and effective and should be promoted in the elderly patients with cancer pain in grassroot hospital.

关 键 词：癌痛 止痛治疗 基层医院 老年患者 不良反应 

分 类 号：R730.5[医药卫生—肿瘤]