应用芬太尼透皮贴剂治疗中重度癌痛的临床体会

Clinical Comprehension of Fentanyl Transdermal System in the Treatment of Moderate and Severe Cancer Pain Patients

目的:观察芬太尼透皮贴剂(多瑞吉)治疗中重度癌性疼痛的疗效及不良反应。方法:回顾性分析采用多瑞吉治疗的慢性中重度疼痛患者中,经济上能完全按照滴定要求用药,且未化疗、放疗、使用破骨细胞抑制剂治疗的66例患者的临床疗效。未曾应用阿片类药物的患者均从25!g/h开始,3天一换,每次加量25!g/h直至满意疗效。使用过阿片类药物的患者按等效止痛换算法来计算多瑞吉剂量。结果:完全缓解30例(45.4%),明显缓解25例(37.8%),中度缓解5例(7.57%),轻度缓解2例(3.03%),总缓解率90.9%;副反应主要有:嗜睡10例(15.1%),恶心15例(22.7%),呕吐6例(9.09%),口干2例(3.03%),便秘13例(19.7%),排尿困难6例(9.09%),中断治疗3例(恶心、呕吐2例,嗜睡1例),完全无副反应15例(22.7%)。结论:多瑞吉使用方便安全,是目前在临床上用以控制中重度癌痛的有效药物。

Objective： To observe the treatment and side effects of transdermal fentanyl （Duro- gesic） on moderate and severe cancer pain. Methods： Sixty-six cases of patients with moderate and severe cancer pain, without chemotherapy, radiotherapy and osteoclast inhibitors, were analyzed retrospectively. The initial dose was 25ug/h for the patients with no previous administration of opioids, the patch was changed every 3 days, another 25ug/h was added if the pain was not relieved satisfactorily. The dose of Durogesic depended on previous use of opioids, if there was. Results： Complete remission 30 cases （45.4%）, apparent remission 25 （37.8%）, moderate remission 5 （7.57%）, mild remission 2 （3.03%）, the total remission rate 90.9%; adverse effects were somnolence in 10 cases （15.1%）, nausea in 15 （22.7%）, vomiting in 6 （9.09%）, dry mouth in 2 （3.03%）, constipation in 13 （19.7%） and dysuria in 6 （9.09%）; 3 cases were drop-out of the treatment because of severe side-effect （2 nausea, vomiting, 1 sleepiness and 15 without any side effect （22.7%）. Conclusion： Durogesic, being convenient and safe, is effective for cancer patients with moderate and severe pain.