口服吗啡用于晚期癌症止痛的家居实践  

The Practice of Oral Morphine for Advanced Cancer Pain Relief with Home Care

作　　者：曹伟华[1] 蔡泽玲[1] 黄少卿[1] 陈素钻[1] 曾怀端[1] 

机构地区：[1]汕头大学医学院第一附属医院宁养院,广东省汕头市515041

出　　处：《中国肿瘤临床》2003年第5期331-333,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨吗啡作为第三阶梯止痛药对晚期癌症患者重度疼痛治疗的效果、剂量滴定及不良反应。方法:按WHO三阶梯癌症止痛原则为393例患者实施含有使用吗啡直至生命最后一周的镇痛治疗方案,口服给药即释吗啡和(或)控释吗啡,24小时剂量范围20～2100mg,用药时间7～374天,以视觉模拟量表(visualanaloguescale,VAS)对所有患者至少每周进行一次疼痛评估,疼痛强度差(painintensitydifference,PID)作为评估疗效指标。结果:364例(92.6%)获中度以上缓解,257例(65.4%)24小时吗啡需求量<300mg,5例(1.2%)吗啡24小时需求量超过1000mg,2例因病情进展出现戒断综合征,未见呼吸抑制及心理依赖。结论:使用口服吗啡安全方便,副作用可耐受,对剧烈疼痛患者吗啡用量不应过于保守。Objective:To approach the clinical effect,titration dosages and sid e effect of oral morphine as the third analgesics ladder for the advanced cancer p atients with severe pain.Methods:393patients suffered from advanced cancer with severe pain were received the anal-gesics con tained morphine till the las t week of life according to the WHO Cancer Pain Relief Program of three-step an algesic ladder.The oral route of analgesic administration remained the most im portant in routine practice(immediate-release tablet and/or controlled-rele ase tablet).The dose range was from20milligram to2100milligram.The pati ents had been followed for seven to three hun dred seventy-four days.All pati ents were assessed at least once a week with visual ana-logue scale(VAS)as th e measurement of pain and pain intensity difference(PID)as the effect index. Results:364cases(92.6%)obtained moderate and upward relief.The morph ine require-ments were less than300milligram each24hours in257cases(6 5.4%)and more than1000milligram in5cases.Two patients appeared withd rawal syndrome as their condition worsened.No respiration in hibition and men tal dependence appeared.Conclusions:The oral morphine was con-venient and sa fe for the advanced cancer patient with severe pain.Its side affect can be sto od under by most patients.It is improper that the morphine dosage should be lim ited accurately in the cancer patients with violent pain.

关 键 词：癌症疼痛 家居止痛 吗啡 

分 类 号：R730.5[医药卫生—肿瘤] R971.2[医药卫生—临床医学]