肺癌患者阿片类药物应用现状与合理性分析:单中心回顾性研究  

Status and Rationality of Opioid Use in Lung Cancer Patients:A Single Center Retrospective Study

作　　者：孙雯娟[1] 胡扬[1] 左玮[1] 张波[1] 徐燕[2] Wenjuan SUN;Yang HU;Wei ZUO;Bo ZHANG;Yan XU(Department of Pharmacy,Peking Union Medical College Hospital,Beijing 100730,China;Department of Respiratory and Critical Care Medicine,Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]北京协和医院药剂科,北京100730 [2]北京协和医院呼吸与危重症医学科,北京100730

出　　处：《中国肺癌杂志》2020年第4期233-238,共6页Chinese Journal of Lung Cancer

基　　金：北京市自然科学基金项目(No.7194311);国家自然科学基金项目(No.81974183)资助。

摘　　要：背景与目的癌痛严重影响患者体力活动、心理状态以及生活质量,甚至缩短患者生存时间,合理规范应用阿片类药物可有效控制癌痛。肺癌患者癌痛发病率高,需分析肺癌患者阿片类药物应用现状,以评估肺癌患者阿片类药物应用的合理性。方法回顾性分析2018年6月-2019年6月北京协和医院呼吸与危重症医学科肺癌住院患者的临床资料,分析305例应用阿片类药物的肺癌癌痛患者的临床信息和用药信息。结果应用阿片类药物的肺癌患者影响因素分析中,年龄与阿片药物应用种类为主要影响因素。男性比例高于女性,且男性患者应用阿片药物种类多、年龄多集中在60岁-69岁之间。我院肺癌患者应用阿片类药物品种和结构符合要求,用药频率最高的为羟考酮缓释片,限定日费用(defined daily cost,DDC)排名第一位同时序号比为1,同步性好。吗啡片和吗啡注射液用量低,肺癌患者整体爆发痛(breakthrough cancer pain,BTcP)控制良好。阿片类药物整体应用合理(93.4%),不合理项目主要为爆发痛处置和用药频率不合理以及超剂量问题。结论应用阿片类药物的肺癌癌痛患者多为男性,老年男性癌痛更难于控制,需要加强关注。我院肺癌患者阿片类药物整体应用合理,但仍需关注BTcP处置、阿片类药物用药剂量和特殊人群用药等问题。Background and objective Cancer pain affect the physical activity,psychological state and quality of life seriously,and even shortened the survival time of patients.Rational and standard application of opioids could control cancer pain effectively.Since the high incidence of cancer pain in lung cancer patients,the status of opioids application should be analyzed to evaluate the rationality of analgesic application in lung cancer patients.Methods The clinical data of 305 patients with lung cancer who were hospitalized in Department of Respiratory and Critical Care Medicine of Peking Union Medical College Hospital from June 2018 to June 2019 were analyzed retrospectively.Results In the analysis of factors affecting the use of opioids in lung cancer patients,age and drug kinds were the main influencing factors.The proportion of male patients was higher than female.Moreover,male patients used more kinds of opioids and were mostly between 60 and 69 years old.The variety and structure of opioids used in lung cancer patients in our hospital met the requirements.Oxycodone hydrochloride prolonged-release tablet has the highest frequency of application,and defined daily cost(DDC)ranked the first with a serial number ratio of 1,which showed good synchronization.The quantity of morphine tablet and morphine injection were low,and the overall breakthrough cancer pain(BTcP)in lung cancer patients was well controlled.The overall application of opioids were reasonable(93.4%),and the unreasonable items mainly included the disposal of BTcP and the unreasonable frequency of opioids,as well as overdose.Conclusion The majority of patients with lung cancer who take opioids are male,and the cancer pain in elderly men are more difficult to control,which needs to pay more attention.The overall application of opioids in the patients with lung cancer pain in our hospital are reasonable,but there are still some problems to focus,such as the disposal of BTcP,the dosage of opioids and the medication of special groups.

关 键 词：肺肿瘤 癌痛 阿片药物 限定日费用 合理性 

分 类 号：R734.2[医药卫生—肿瘤]