癌痛患者疼痛门诊药物治疗的临床效果分析.pdf

中国肿瘤临床年第卷第期ChinJClinOncol
1506201340242013,Vol.40,No.24www.cjco.cn

癌痛患者疼痛门诊药物治疗的临床效果分析

史鹤玲①李雪冰①张同梅①胡范彬①吕嘉林②孟弃逸③李宝兰①

摘要目的：探讨癌痛规范化治疗中癌痛患者疼痛门诊镇痛药物治疗效果及不良反应的临床分析。方法：对年月至
20124
年月首都医科大学附属北京胸科医院疼痛门诊癌痛患者诊治情况每月汇总，分析引起癌痛的疾病种类，癌痛原因、分类、
20134
程度，药物治疗种类，疗效及不良反应等。结果：疼痛门诊收治患者例。镇痛药物用药途径以口服为主例（）。使用
78768086.4%
单一药物盐酸羟考酮缓释片例（），日剂量～为疼痛控制。例（）患者以阿片类药物单一治疗为主，
43054.6%2090mg/d63280.3%
少数患者联合～种药物治疗。规范治疗后与治疗前比较中重度疼痛患者比较明显减少（vs.），无痛患者增多。不
2331.5%55.5%
良反应方面，例（）患者使用阿片类药物易引起便秘，轻度恶心呕吐、头晕、嗜睡、食欲减退、尿潴留、口干、腹胀、幻觉症状
25432.3%
均可耐受，少数患者需干预处理预防或对症治疗。结论：在医院创建癌痛规范化治疗示范项目中疼痛门诊作用不容忽视，规范管
理意义重大。疼痛门诊的设立使癌痛规范化治疗成为示范病房的延续。
关键词癌痛癌痛规范化治疗示范病房疼痛治疗疼痛门诊

doi:10.3969/j.issn.1000-8179.20131980
Clinicalanalysisofstandardizeddrugtreatmentofcancerpainat
thepainclinic
HelingSHI1,XuebingLI1,TongmeiZHANG1,FanbinHU1,JialinLU2,QiyiMENG3,BaolanLI1
Correspondenceto:BaolanLI;E-mail:[e-mail]
1GeneralDepartment,2No.2DepartmentofOncologyand3No.1DepartmentofOncology,BeijingChestHospitalofCapitalMed-
icalUniversity,Beijing101149,China
AbstractObjective:Toobservetheefficacyandsafetyofanalgesicdrugsinthestandardizedtreatmentofcancerpainpatients
atthepainclinic.Methods:Thedataof787cancerpainpatientsandtheircorrespondingprescriptionsforcancerpainwerecollected
fromApril,2012toApril,2013atthepainclinic.Theobtainedinformationcompriseofdiseasesthatleadtocancerpain,causeofpain,
painintensity,andefficacyandsideeffectsofmedications.Diseasesthatcausedcancerpaininclude658caseswithprimarymalignant
lungcancer.Results:Painwasmainlycausedbyprimarylungcancerin787cancer-relatedpatients.Ananalgesicdrug,namely,oxyco-
donehydrochloride,wasadministeredin54.6%viasingledrugtherapy.Thedailydosagerangeofthisdrugwas20to90mg/din280
cases.About35.6%ofthestudiedpatientswithadailydosageof90mg/dorlowerhadtheirpaineffectivelymanaged.Afterthetreat-
ment,thenumberofcaseswithmoderatetoseverepainwasreducedfrom437(55.5%)to248(31.5%).Theoraladministrationofopi-
oidoxycodonehydrochloridetabletsrankedfirstamongtheprescribeddrugsforcancerpain,andsingle-drugther