晚期癌症患者麻醉性镇痛药物的应用研究

摘要

Objective To study the use of narcotic analgesic drugs use in advanced cancer pain,and to provide reference for clinical rational use of drugs.Methods Variety, specification, number of prescriptions, dosage, defined daily dose system ( DDDS) and medication of narcotic analgesics drugs in 70 cases of advanced cancer patients were retrospectively analyzed.Re-sults There were mainly 7 kinds of narcotic analgesic drugs used,including 3 kinds of injection,3 kinds of tablets ( controlled-release tablets) and 1 patch.Cancer pain patients who used narcotic analgesic drugs had significant gender differences,there were more men than women,more elderly patients than young patients.DDDS from high to low in turn were:fentany transdermal system﹥slow releasing morphine hydrochloride﹥morphine hydrochloride injection﹥oxycodone hydrochloride prolonged-release tab-lets﹥slow releasing tramadol hydrochloride﹥tramadol hydrochloride injection﹥dezocine injection.Drug DUI ( drug utilization index) in turn were:slow releasing morphine hydrochloride﹥morphine hydrochloride injection﹥Fentany Transdermal System﹥tramadol hydrochloride injection﹥ slow releasing tramadol hydrochloride﹥dezocine injection ﹥ oxycodone hydrochloride prolonged-release tablets.Conclusion The use of narcotic analgesic drugs in advanced cancer patients conform to WHO cancer pain 3 step analgesic ladder,The use of narcotic analgesic drugs is basically reasonable,but there are still some shortcomings that need further improvement.%目的：分析晚期癌症患者麻醉性镇痛药物的使用情况，为临床合理用药提供参考依据。方法回顾性分析70例晚期癌症患者使用麻醉性镇痛药的品种、规格、处方数、用药量、用药频度（ DDDS）及其用药情况。结果使用的麻醉性镇痛药物主要有7种，注射液3种、片剂（缓控释片剂）3种、贴剂1种。使用麻醉药品的癌痛患者男女比例相差较大，男性比女性多，老年患者是所有年龄段最多的人群；用药频度（ DDDS）由高到低依次为：芬太尼透皮贴剂﹥盐酸吗啡缓释片﹥盐酸吗啡注射液﹥盐酸羟考酮缓释片﹥盐酸曲马多缓释片﹥曲马多注射液﹥地佐辛注射液。各药品DUI （药物利用指数）依次是：盐酸吗啡缓释片﹥盐酸吗啡注射液﹥芬太尼透皮贴剂﹥曲马多注射液﹥盐酸曲马多缓释片﹥地佐辛注射液﹥盐酸羟考酮缓释片。结论晚期癌痛麻醉性镇痛药的使用基本符合WHO癌症疼痛三阶梯止痛原则，麻醉性镇痛药物的使用也基本合理，但依然存在一些缺点需要进一步改善。