100例门诊中重度老年癌痛患者使用3种阿片类药物疗效回顾性分析

摘要

目的 回顾性分析100例门诊中重度老年癌痛患者3种阿片类药物疗效及不良反应情况. 方法 选择100例中重度老年癌痛患者(≥60岁),规范单一使用硫酸吗啡控释片、盐酸羟考酮控释片及芬太尼透皮贴剂3种阿片类药物,利用简明疼痛调查量表(BPI)对患者治疗前、后镇痛效果及不良反应情况进行调查和分析.结果 患者药物治疗后数字分级评估法(NRS)评分较治疗前低(P＜0.05).疼痛缓解总有效率为91.0％.药物的主要不良反应有便秘、恶心呕吐、排尿困难、嗜睡及瘙痒、精神症状等,年龄越大药物不良反应越明显.芬太尼贴剂组患者不良反应不如其他2组明显(P＜0.05). 结论 3种阿片类药物对中重度老年癌痛患者均有效,药物选择要兼顾老年患者特点及药物特性,药物不良反应不可忽视,应采取综合措施防范.%Objective To analyze the treatment effect and side effect of three kinds of opioid drugs on 100 cases of elderly patients with moderate and severe cancer pain. Methods 100 cases of older patients(≥60 years old) with moderate and severe cancer pain were selected and used only one of the Durogesic, MS Contin and Oxycontin was used rationally. The treatment effect and side effect was investigated with BPI. Results NRS scores after treatment was less than that before treatment (P<0.05). The total relief rate was 91.0%. Main side effects were constipation, nausea and vomiting, dysuria, sleepiness, itching and psychiatric symptoms. The older patients showed more obvious side effects. The incidence of side effects in Durogesic group was less than that in the other two groups (P<0.05 ). Conclusions Three kinds of opioid drugs are effective in treatment for old patients with moderate and severe cancer pain. We must balance the features of old patients and opioid drugs when we prescribe the opioid drugs for old patients. The side effects of opioid drugs should be paid more attention and comprehensive measures should be taken to avoid them.