【摘要】 目的:观察盐酸羟考酮控释片(奥施康定)治疗中重度癌痛的疗效及不良反应。方法:38例患者均为经病理组织学或细胞学证实VAS评分>4分的中、重度癌痛患者,既往没有应用过阿片类药物,能合作进行疼痛评价,年龄36～72岁,中位年龄55岁,男性25例,女性13例,预计其生存期在2个月以上,无严重并发症,肝肾功能无严重障碍,入院后第2天始给予口服奥施康定10mg,每12小时一次,同时根据疼痛的不同类型予以NSAIDs、抗惊厥、抗抑郁等相应辅助药物,服药24小时镇痛效果不佳的增加原日剂量的25%～50%。每天记录VAS、KPS评分及不良反应出现情况,至少观察2周,共观察4周,用药期间根据不良反应严重度予以相应处理。同时根据患者原发疾病给予相应的化放疗等综合治疗。结果:38例患者中首次用药后89.5%的患者在60分钟内起效,平均镇痛起效时间46分钟,第3天中度以上疼痛缓解率可达92.1%,2周后94.7%的患者平均镇痛时间12小时以上,Karnofsky生活质量评分(KPS)提高10分以上者20例(52.7%),不良反应主要为便秘9例(23.7%),头晕6例(15.8%),恶心、呕吐5例(13.2%),嗜睡2例(53%),兴奋2例(5.3%),尿潴留1例(2.6%),无因严重不良反应而停药的病例。结论:盐酸羟考酮控释片治疗中重度癌痛,起效快,镇痛效果好,副反应可控,改善了生活质量,是临床医生和患者的一种较好选择。更多还原

【Abstract】 Objective:To investigate the clinical efficacy and main side effects of Oxycodone hydrochloride controlled-release tablets (oxycontin) on moderate to severe cancer pain.Methods:A total of 38 patients pathologically diagnosed with malignant tumors who suffered from moderate to severe pain (VAS scale>4) were studied.Among these patients,no one had taken opioids before.The mean age was 55 years old (ranging from 36 to 72).There were 25 males and 13 females.No severe heart,liver or renal dysfunction was observed. Oxycontin was administered at an initial dose of 10 mg q12h onth e second day after hospital admission and titrated according to the degree of pain relief.At the same time NSAIDs and other supplementary drugs were used according to the type of pain.Evaluated outcomes included analgesic effect,Karnofsky performance status scales (KPS) and side effects.The minimum duration of Oxycontin treatment was at least 2 weeks.Radiotherapy or chemotherapy was also administered.Results:The time to onset of analgesic effect was less than 60 minutes in 89.5% of the 38 patients,and the mean time was 46 minutes.Moderate pain relief occurred in 35 (92.1%) patients on the third day.The mean duration of analgesic effect was more than 12 hours in 36 (94.7%) patients after 2 weeks.The Karnofsky score rose by over 10% in 20 cases (52.6%).The main adverse effect was constipation in 9 cases (%),dizziness in 6 cases (15.8%),and nausea and vomiting in 5 cases (13.2%).Conclusion:Oxycontin works quickly,safely and effectively and has comparatively slight side effects in the treatment of moderate to severe cancer pain.It is a good choice for treating cancer pain.更多还原