临床药师在癌痛患者镇痛治疗中的作用与体会

The Role of Clinical Pharmacists in the Analgesic Treatment of Cancer Patients

目的:评价临床药师在癌痛患者镇痛治疗中的作用。方法:采用前瞻性对照研究方法,将2011年3月～2012年2月在我院肿瘤内科病房住院的符合病例选择标准的224例癌痛患者等间隔分为观察组、对照观察组和对照组各112例;临床药师为观察组患者及其相关人员提供药学服务,记录两组患者随访3个月的药物治疗情况及疼痛评分。结果:开始治疗1个月内患者应用镇痛药物情况,组间差异有统计学意义(P=0.013)。两组患者经7日综合治疗后,重度疼痛基本缓解。患者治疗第7日疼痛程度组间差异无统计学意义(P>0.05),但每组患者疼痛程度与治疗前比较,组内差异均有显著统计学意义(P<0.01)。治疗第15日,两组患者疼痛状况趋于稳定,疼痛程度组间比较差异有显著统计学意义(P<0.01);每组患者疼痛程度与其治疗前比较,组内差异也有显著统计学意义(P<0.01)。第30日、45日、60日、90日,在同一时间点患者疼痛程度组间差异均有统计学意义(P<0.05)。结论:临床药师参与癌痛患者镇痛治疗,可以明显提高患者用药合理性、依从性,有效缓解患者的长期疼痛。

Objective： To evaluate the role of clinical pharmacists played in the cancer patients who were in pain receiving analgesic treatment. Methods ： This was a prospective controlled study. 224 cancer patients who hospitalized in the oncology medical ward of our hospital from March 2011 to February 2012, according with the selection criteria, were equally divided into trial group and control group. Clinical pharmacists provided pharmaceutical care to the cancer patients and relevant staff in the trial group. Drug treatment and pain evaluation of every patient were recorded within 3 months follow-up. Results： There was a significant difference between the two groups in the use of analgesic drug within the first month （P=0.013）. After combined therapy about 7 days, severe pain was almost relieved. There was no significant difference in pain intensity between two groups （P〉0.05） on the 7th day, but there was a significant difference in each group compared with untreated condition （P〈0.01）. On the 15th day, pain conditions of patients became stabilized, and there were significant differences between-groups in pain degree. There was significant difference in pain of each group between pre-therapy and the 15th day （P〈0.01）. On the 30th, 45th, 60th, and 90th day of initial treatment, pain intensity difference at the same time were statistically different between two groups （P〈0.05）. Conclusion ： Participating in the analgesic therapy for cancer patients who were in pain, clinical pharmacists could significantly improve rationality and compliance of cancer patients＇ medication, and effectively alleviate the cancer patients＇ long-term pain.