芬太尼透皮贴剂缓解老年晚期癌痛及对生活质量的影响

Effects of transdermal fentanyl for relieving advanced cancer pain and quality of life in elder patients

目的:观察芬太尼透皮贴剂治疗老年晚期癌痛的临床疗效、不良反应及使用后生活质量的改善程度。方法:选取30例伴有中、重度疼痛的老年恶性肿瘤患者,使用芬太尼透皮贴剂止痛,至少应用5贴,观察15d,记录治疗前后的疼痛强度、生活质量评分和用药中的不良反应。结果:使用芬太尼透皮贴剂后获得完全缓解20%(6/30),明显缓解30%9/30),中度缓解40%12/30),轻度缓解3.33%1/30),未缓解(((6.66%2/30),总止痛有效率90%,总获益率93.33%。中度疼痛缓解(率91.67%(11/12),重度疼痛缓解率88.89%(16/18)。不良反应有头晕、嗜睡、便秘、恶心、呕吐、排尿困难、皮肤过敏等,无危及生命的严重不良反应,生活质量明显改善。结论:芬太尼透皮贴剂治疗老年晚期癌痛疗效显著,尤其适用于不能耐受口服止痛药的老年患者。

AIM:To observe the improving level of clinical effect, adverse reaction and quality of life(QOL) after the treatment of cancer pain in elder patients by using transdermal fentanyl(TDF). METHODS:Thirty elder patients with malignant tumor and moderate severe degree cancer pain were selected.Each patient had at least 5 pieces of TDF for 15 day observation. The pain intensity, the QOL score and adverse reaction were recorded before and after treatment. RESULTS:The results showed that the complete remission rate was 20%(6/30), the obvious remission rate was 30%(9/30), the moderate remission rate was 40%(12/30), the mild remission rate was 3.33%(1/30),and the unremission rate was 6.66%(2/30).The total pain remission rate was 90%,the total benefit rate was 93.33%,the moderate pain remission rate was 91.67%(11/12),and the severe pain remission rate was 88.89%(16/18).The adverse reactions included dizziness,drowsiness,constipation, nausea, vomiting,difficulty urination,cutaneous anaphylaxis and so on.There was no severe adverse reaction which endangered people's lives,and the QOL was improved obviously. CONCLUSION:TDF is significantly effective on the treatment of moderate and severe cancer pain in elder patients,especially for those who cannot tolerate the oral antalgica.