癌痛住院患者阿片类药物合理使用分析

Analysis of the rational use of opioids in hospitalized patients with cancer pain

目的对我院住院的癌痛患者治疗进行调查分析,为临床合理使用阿片类药物提供参考。方法检索我院2012年1月至12月癌痛住院患者的电子病历,对阿片类药物进行用药频度(DDDs)、药物利用指数(DUI)、癌痛分布、癌症患者出院疼痛评分和用药合理性进行评价。结果共计286例癌痛治疗患者,癌痛控制不佳有82例,占比28.7%;余204例疼痛强度≤3。阿片类长效制剂曲马多缓释片、芬太尼透皮贴剂、盐酸羟考酮缓释片、吗啡缓释片分别为DDDs前4位,在各型癌痛治疗中占主导地位。部分科室不合理使用哌替啶注射剂比例较高。结论阿片类药物的使用基本合理,还应更严格按照癌症疼痛诊疗规范使用阿片类药物,癌痛规范化治疗示范病房的创建还需要进一步深化。

AIM To investigate opioids utilization of cancer ached inpatients in our hospital and to provide refer- ence for the rational use of opioids. METHODS The DDDs, DUI, the distribution of cancer pain, pain scores of the discharged patients and the use of opioids were investigated by retrieving the patients＇ medical records between January and December in 2012. RESULTS Ahogether 286 patients were recruited and treated. Among them, 82 patients＇ pain score ≤ 3. The top four opioids of DDDs were tramadol hydrochloride sustained release tablets, fentanyl transdermal system, oxycodone hydrochloride prolonged-release tablets and morphine hydochloride sustained-release tablets, which played the vital roles in treatment of cancer pain. And the improper use of pethidine was a common phenomenon among different departments. CONCLUSION The use of opioids is basically rational, but it is imperative to use opuiuds in strict accordance with the cancer pain clinical norms and cancer pain standardized treatment demonstration ward need to further deepen.