芬太尼透皮贴剂治疗肺癌骨转移癌痛临床观察

Clinical observation of fentanyl transdermal system treating bone pain from metastases of lung cancer

目的：观察芬太尼透皮贴剂治疗肺癌骨转移引起癌痛的镇痛效果以及不良反应。方法选择32例中、重度肺癌骨转移的癌痛患者，使用芬太尼透皮贴剂止痛治疗，观察其止痛效果、生活质量变化以及不良反应。结果治疗前疼痛强度（PI）评分为（7．62＆#177;1．35）分，治疗后为（1．93＆#177;2．41）分，治疗前后差异有统计学意义（t ＝3．983，P ＜0．01）；32例患者中，完全缓解12例（37．5％），明显缓解11例（34．3％），中度缓解7例（21．8％），轻度缓解2例（6．3％），总缓解率93．7％；不良反应：嗜睡13例，头晕11例，恶心、呕吐6例，便秘5例，皮肤瘙痒、皮疹4例，排尿困难2例，上述不良反应在停药和／或对症处理后均消失。结论芬太尼透皮贴剂使用简单、方便，止痛效果明显，不良反应少。

Objective To observe the effect and adverse reaction of fentanyl ransdermal system on the cancer pain resulted from lung cancer metastasizing to bone.Methods Thirty -two patients with moderate to severe cancer pain of bone metastasis from lung cancer were treated with fentanyl transdermal system.Analgesic effect was observed.The quality of life and adverse reactions were evaluated.Results The PI evaluation were （7.62 ＆#177; 1.35）and （1.93 ＆#177;2.41）before /after treated with fentanyl ransdermal system.The differences of bone pain between before and after treated were significant（t =3.983,P 〈0.01）.Among the thirty -two patients with moderate to severe cancer pain used by fentanyl transdermal system,complete relief was in 12 cases（37.5%）,apparent relief was in 11 cases（34.3%）,moderate relief was in 7 cases（21.8%）,mild relief was in 2 cases（6.3%）,the total relief rate was 93.7%.The adverse reactions included hypersomnia were in 13 cases,dizziness in 11 cases,nausea and vomiting in 6 cases,constipation in 5 cases,pruritus and erythra in 4 cases,dysuria in 2 cases.All above adverse reactions dis-appeared after stopping fentanyl ransdermal system and /or undergoing symptomatic treatment.Conclusion Fentanyl transdermal system is easy to use,the effect is significant,there is few adverse reactions,which can significantly improve quality of life of cancer patients.