家中应用芬太尼透皮贴剂治疗中重度癌症痛疗效观察

Analgesic Effect of Transdermal Fentanyl to Moderate or Severe Cancer Patients Treated at Home

目的探讨应用芬太尼透皮贴剂(多瑞吉)在家中治疗中、重度癌症痛患者的可行性和治疗效果。方法由专业医师组成治疗小组,对116例中、重度癌症痛患者应用芬太尼透皮贴剂,在家中实施镇痛治疗,初始剂量为25μg/h或参照吗啡与芬太尼剂量转换公式计算。贴剂每72 h更换1次,其间根据患者的疼痛程度进行剂量调整,并进行疼痛缓解度和生活质量评分与观察随访。结果116例中、重度癌症痛患者的疼痛缓解率为98.27%,患者治疗的依从性好,生活质量明显提高。治疗剂量最小为25μg/h,最大为375μg/h,平均治疗时间为90.5 d。主要的不良反应有头晕、恶心、便秘和皮肤过敏。结论芬太尼透皮贴剂是一种使用方便、不良反应较轻、疗效确定的镇痛药,适宜中、重度癌症痛患者在家中使用。

Objective To assess the analgesic effects of Transdermal Fentanyl（Durogesic） to moderate or severe cancer patients treated at home. Methods 116 moderate or severe cancer patients with pain received a .pain relieving treatment offered by a group of qualified doctors. The trial dosage of Transderrnal Fentanyl is 25μg/h or dosages referred to a conversion formula from morphine to Transdennal Fentanyl. The plaster will be changed with a new one after every 72 h. Dosage could be adjusted according to patients＇ reaction. Results After follow-up interviews, the effects and adverse reactions of Durogesic were observed. 98.27% of patients were observed to relieve pain and the quality of life was significantly improved after use of Transdermal Fentanyl. The minimum dosage of Transdermal Fentanyl was 25 μg/h and the maximum 375 μg/h, average time of treatment was 90.5 d. The main adverse reactions were dizziness, nausea, constipation and skin allergy. Conclusion In summary, Transdennal Fentanyl is a kind of ideal analgesic which has the advantage of convenience and low rate of adverse reactions. It suits moderate or severe cancer patients who treated at home.