阿片类药物治疗中晚期癌症患者癌痛的临床效果

Clinical effect of opioids in the treatment of cancer pain in patients with intermediate and advanced cancer

目的观察盐酸羟考酮缓释片联合盐酸吗啡片治疗中晚期癌症患者癌痛的临床效果。方法选择210例中重度癌痛患者进行2周以上的阿片类药物治疗及随访,收集相关治疗数据。比较不同年龄、性别、肿瘤部位及体质量指数(BMI)患者的癌痛缓解率、数字评分量表(NRS)评分、吗啡日均用量,分析不良反应发生情况。结果不同年龄患者的癌痛缓解率、NRS评分、吗啡日均用量比较,差异无统计学意义(P>0.05)。男性和女性患者的癌痛缓解率、NRS评分、吗啡日均用量比较,差异无统计学意义(P>0.05)。不同肿瘤部位患者的癌痛缓解率、NRS评分比较,差异无统计学意义(P>0.05);不同肿瘤部位患者的吗啡日均用量比较,差异具有统计学意义(P<0.05)。不同BMI患者的癌痛缓解率、NRS评分比较,差异无统计学意义(P>0.05);不同BMI患者的吗啡日均用量比较,差异具有统计学意义(P<0.05)。患者应用阿片类药物期间出现的不良反应主要为便秘。结论在以阿片类药物为主的癌痛治疗过程中,肿瘤部位及BMI是影响药物用量的重要因素。

Objective To observe the clinical effect of oxycodone hydrochloride sustained-release tablets combined with morphine hydrochloride tablets in the treatment of cancer pain in patients with intermediate and advanced cancer.Methods A total of 210 patients with moderate to severe cancer pain were selected for more than 2 weeks of opioids treatment and follow-up,and relevant treatment data were collected.The remission rate of cancer pain,Numerical Rating Scale(NRS)score,average daily dose of morphine were compared among patients with different ages,genders,tumor sites and body mass index(BMI),the occurrence of adverse reactions was analyzed.Results There were no significant differences in the remission rate of cancer pain,NRS score and average daily dose of morphine among patients of different ages(P>0.05).There were no significant differences in the remission rate of cancer pain,NRS score and average daily dose of morphine between male and female patients(P>0.05).There were no significant differences in the remission rate of cancer pain and NRS score between patients with different tumor sites(P>0.05);there was statistically significant difference in the average daily dose of morphine in patients with different tumor sites(P<0.05).There were no significant differences in the remission rate of cancer pain and NRS score between patients with different BMI(P>0.05);there was statistically significant difference in the average daily dose of morphine in patients with different BMI(P<0.05).The adverse reactions during the use of opioids in patients was mainly constipation.Conclusion In the treatment of opioid-based cancer pain,tumor site and BMI are important factors affecting drug dosage.