芬太尼透皮贴剂在鼻咽癌治疗相关口腔黏膜疼痛中的应用价值

The Effect of Transdermal Fentanyl on Oral Mucositis Pain in Patients with Nasopharyngeal Cancer

目的:探讨芬太尼透皮贴剂在鼻咽癌治疗相关的口腔黏膜中-重度疼痛中的镇痛疗效及安全性。方法:利用芬太尼透皮贴剂治疗同期化放疗中出现口腔黏膜反应中-重度疼痛的鼻咽癌患者的41例,采用自身对照方式进行比较治疗前后患者疼痛缓解情况及患者生存质量的变化,并观察其毒副作用。结果:治疗后疼痛总缓解率为95.12%,其中完全缓解14.63%,部分缓解80.49%;治疗前比治疗后疼痛VAS评分减少(Z=-5.62,P=0.00<0.05),而生存质量KPS评分则增加,并且差异有显著性(Z=-5.57,P=0.00<0.05);不良反应为轻度的头晕不适、嗜睡、恶心、呕吐、胃部不适、皮疹及腹泻,经对症处理后逐渐缓解。结论:芬太尼透皮贴剂治疗鼻咽癌相关的口腔黏膜疼痛是有效、安全的,并能显著改善患者的生存质量,其使用简单、无创伤,值得临床上进一步应用。

Objective： To investigate the efficacy and safety of transdermal fentanyl for the treatment of severe pain due to oral mucositis in patients with nasopharyngeal neoplasms （NPC）. Methods： Forty-one NPC patients with moderate to severe pain due to oral mucositis caused by chemoradiotherapy received transdermal fentanyl. The degree of pain and the quality of life before and after therapy were compared, and the adverse reactions were observed. Results： The overall remission rate was 95.12%, the complete remission rate was 14.63%, and the partial remission rate was 80.49%. The VAS score was decreased （Z=-5.62, P=0.00） and the quality of life was improved significantly （Z=-5.57, P=0.00）. The adverse effects included mild dizziness, drowsiness, nausea, vomiting, stomach discomfort, skin rash, and diarrhea. All the symptoms disap- peared within several days after proper management. Conclusion： Transdermal fentanyl has a good analgesic effect on severe pain due to treatment-related oral mucositis in NPC patients. Transdermaf fentanyf is convenient, well tolerated with mild toxicities, and capable of improving patients＇ quality of life.