芬太尼透皮贴剂治疗晚期癌症疼痛的临床应用

Ginical application of transdermal fentanyl (Durogesic) in treatment of cancer pain

目的 观察芬太尼透皮贴剂(多瑞吉)治疗晚期癌症中、重度疼痛的临床效果、不良反应及患者生活质量的改善情况。方法224例中、重度癌痛患者给予芬太尼透皮贴剂镇痛治疗,初始剂量25μg/h或参照吗啡与芬太尼剂量折算表计算,贴膜每3 d更换1次,根据疼痛情况调整剂量,直到患者无痛或基本无痛,每位患者至少治疗15 d以上,同时进行疼痛强度、生活质量评分及不良反应观察。结果芬太尼的最终滴定剂量为每小时25μg者90例,50μg者67例,100μg者37例,150μg者28例,200μg者2例。总疼痛缓解率为96.4％,其中完全缓解94例(41.9％),明显缓解110例(49.1％),中度缓解12例(5.4％)。患者生活质量明显提高,不良反应少且较轻微。结论芬太尼透皮贴剂治疗中、重度癌痛疗效显著,使用简单方便,不良反应少,能够改善癌症患者的生活质量,尤其适用于不能口服止痛药的患者。

Objective To evaluate the efficacy, adverse effects and life quality-improving effect of trans-dermal fentenyl (Durogesic)in treatment of patients with cancer pain. Methods Two hundred twenty-four patients with moderate or severe cancer pain were treated with Durogesic. The initial dosage was 25 ug/h or based on the Conversion Table of Morphine Dosage over Durogesic. The Durogesic was changed every 3 days. During the therapeutic course, the dosage was adjusted according to the patient's feeling until painless or nearly painless. Each patient was at least treated for 15 days. The severity of pain, the life quality score and the adverse effects were observed after use of Durogesics. Rusults The final titrated dosages of fentanyl were 25 ug (90 cases) ,50 jug (67 cases) , 100ug (37 cases) , 150ug (28 cases)and 200ug (2 cases) .The total remission rate of pain was 96.4% , the excellent,effective and moderate remission rates were 41.9% ,49.1% and 5.4% respectively.It had a few and mild adverse effects and the life of quality patients improved markedly. Conclusions Durogesic is significantly effective in treatment of moderate and severe cancer pain. The administration is simple and convenient and side effects are mild. Durogesic can improve the life quality of patients markedly, especially for alimentary tract cancer patients who can not take analgesics orally.