2017年云南省第一人民医院门诊癌性疼痛患者阿片类镇痛药应用分析

Analysis on Application of Opioid Analgesics for Cancer Pain Patients in Outpatients form Yunnan the First People's Hospital in 2017

目的:了解2017年云南省第一人民医院(以下简称"我院")门诊癌性疼痛患者阿片类镇痛药的使用情况,为合理用药提供参考。方法:对2017年我院门诊收治的205例癌性疼痛患者的性别、年龄、病种和阿片类镇痛药使用情况等进行回顾性统计分析,比较治疗前后患者疼痛程度的差异。结果:205例癌性疼痛患者中,男性131例(占63.90%),女性74例(占36.10%);>60～80岁患者最多(100例,占48.78%),其次为>40～60岁者(77例,占37.56%);肺癌患者最多(88例,占42.93%);治疗后,中重度疼痛患者所占比例由治疗前的95.12%(195例)明显降至53.66%(110例),差异有统计学意义(P=0.001);174例患者(占84.88%)所用阿片类镇痛药的剂型为片剂;盐酸羟考酮缓释片的使用量排序、销售金额排序均居第1位;108例患者(占52.69%)就诊次数≥12次,其规律使用麻醉性镇痛药的时间≥180 d,与临床药师参与癌性疼痛患者规范化管理有关。结论:我院门诊使用阿片类镇痛药治疗癌性疼痛时,在用药种类、剂型及给药途径方面基本合理;临床药师参与门诊癌性疼痛患者的规范化管理,有助于提高阿片类镇痛药的治疗效果及安全性。

OBJECTIVE： To investigate the application status of opioid analgesics for cancer pain patients in outpatients form Yunnan the First People＇s Hospital（hereinafter referred to as ＂our hospital＂）, so as to provide reference for rational drug application. METHODS： Retrospective analysis was conducted on data of 205 cancer pain patients admitted into outpatients of our hospital in 2017, in terms of patients＇ gender, age, disease, application of opioid analgesics. Differences of cancer pain were compared before and after treatment. RESULTS： Of the 205 patients with cancer pain, 131 were male（63.90%） and 74 were female（36.10%）. Patients aged 60-80 years took the lead（100 cases, 48.78%）, followed by 40-60 years（77 cases, 37.56%）. And lung cancer patients also took the lead（88 cases, 42.93%）. After treatment, the proportion of patients with moderate to severe pain significantly decreased from 95.12%（195 cases） before treatment to 53.66%（110 cases）, the difference was statistically significant（P=0.001）. The dosage form of opioid analgesics used in 174 patients（84.88%） was tablet. The consumption amount, consumption sum of Oxycodone hydrochloride sustained-release tablets dominated the first place. There were 108 patients（52.69%） who visited more than 12 times, and the regular application of narcotic analgesics was ≥180 d, which was related to the clinical management of participation of clinical pharmacists for patients with cancer pain. CONCLUSIONS： The application of opioid analgesics for cancer pain patients in our hospital is basically rational in terms of types, dosage form and route of administration; clinical pharmacists＇ participation in the standardized management of outpatients with cancer pain can help to improve the treatment effect and safety of opioid analgesics.