美沙酮治疗阿片耐受患者中重度癌性疼痛的临床观察

CLINICAL OBSERVATIN OF METHADONE IN THE TREATMENT OF 30 CASES IN OPIOID TOLERANT PATIENTS WITH MODERATE AND SEVERE CANCER PAIN

目的:观察美沙酮治疗阿片耐受患者中重度癌性疼痛的疗效及不良反应。方法:对前期使用过吗啡和羟考酮的27例阿片耐受的中重度癌性疼痛患者。采用NCCN成人癌痛指南剂量转换方法,转换为美沙酮。分别记录药物使用剂量、疼痛缓解度及不良反应等。结果:27例患者中疼痛完全缓解3例(11.11%),部分缓解23例(85.16%),总的疼痛缓解率96.29%,其中中度疼痛缓解率为94.44%,重度疼痛缓解率为100%。患者生活质量明显提高,不良反应轻微。结论:美沙酮可有效控制阿片耐受患者的疼痛,不良反应较少。

Objective：To evaluate the effect and adverse reactions of methadone in patients with opioid tolerance. Metho.d.s. ： On the basis of the NCCN Clinical Practice Guidelines in Oncology, morphine and oxycodone were converted to methadone in thirty patients with cancer pain, simultaneously the doses, analgesic effect and adverse effects was investigated. Results： Among the tewenty - seven patients suffering moderate andsevere chronic cancer pain, 3 （11. 11% ） achieved complete remission, 23 （85.16%） achieved partial remission, total pain relief was 96.29%, and it was 94.44% in patients with moderate chronic cancer pain, 100% in patients with severe chronic cancer pain. The quality of life was significantly improved after the treatment with mild adverse effect. The main adverse reactions were constipation, followed by nausea, vomiting, somnolence, dizziness. Conclusion ： Methadone are effective in controlling moderate and severe chronic cancer pain, and the adverse effect in the groups were fewer.