癌痛治疗120例临床分析

A Clinical Study on Management of 120 Cases with Cancer Pain

目的调查中重度癌痛患者强阿片类及第一类精神药物的使用情况。方法从疾病类别、患者年龄及性别方面,回顾性分析120例中重度癌痛患者使用强阿片类药物、曲马多口服制剂、盐酸布桂嗪针剂的情况。结果使用强阿片类药物的患者中,男性多于女性(P=0.004<0.05)。强阿片类、曲马多口服制剂及盐酸布桂嗪针剂的日最大剂量男性均大于女性。使用强阿片类药物(P=0.030<0.05)和盐酸布桂嗪针剂者(P=0.019<0.05)的日平均剂量,男性也大于女性。≥60岁组便秘发生率高于<60岁组,差异具有统计学差异(P=0.023<0.05)。结论癌痛患者中男性使用强阿片类药物的比率高于女性,且强阿片类药物与盐酸布桂嗪针剂的日平均应用剂量也高于女性。50～59岁组强阿片类药物的日平均应用剂量最高。因强阿片类药物对老年患者的不良反应较重,尤其是便秘,该类药用药剂量应酌减。

Objective To investigate strong-opioid and psychotropic substancesⅠanalgesic management for cancer patients on severe and moderate cancer pain.Methods A retrospective survey was conducted to analyze cancer pain management in 120 cancer patients and to compare strong-opioid,oral tramadol and bucinnazine hydrochloride injection application between different groups according to the disease classification,age and gender.Results Among the cases receiving opioid therapy,there was significant increase in the number who received trong-opioid treatment in male patients（P=0.004P0.05）.There was significant increase in the total daily mean oral morphine（P=0.0300.05）and bucinnazine hydrochloride injection（P=0.0190.05） equivalent in male patients,compared to female patients.The older the patients,the lower dose needed to alleviate their pain.Conclusion More male patients receiving stong-opioid therapy than female.The male patients require more morphine and bucinnazine hydrochloride injection than females to achieve similar pain relief.50~59 years old group patients needed the highest dose strong-opioid.Elderly patients tend to have more side-effects especially astriction and alleviate cancer pain with lower dose strong-opioid.