【摘要】 目的:评价儿童癌痛;探讨不同年龄组儿童中、重度疼痛的除痛药物、剂量及安全性。方法:选择46例3～14岁、中晚期癌症患儿,分为4岁以下、5～7岁、8～14岁三个不同年龄组。分别采用代述法、自述法或两者结合的方法对疼痛部位和疼痛强度予以评价,按WHO三阶梯除痛治疗原则,对中度疼痛给予复方可待因制剂(路盖克),无效者改用吗啡类药物美施康定(MST);对重度疼痛则首选吗啡类药物。临床观察疼痛缓解率和不良反应。结果:中度疼痛15例,重度疼痛31例。中度疼痛患儿给予路盖克后仅2例缓解(13.2%),无缓解者改用MST后全部缓解;重度疼痛患儿给予MST,除2例因排尿困难停药者亦全部缓解。吗啡类药物治疗总缓解率为93.4%。不良反应为嗜睡、便秘、恶心,发生率分别为36.4%、27.2%和17.9%,无戒断症状发生。结论:1)对不同年龄组癌痛患儿应分别采用代述法、自述法和两者结合的方法予以癌痛评价;2)对重度疼痛患儿按原则给予适量吗啡类药物可达到很好的除痛效果;3)癌痛儿童因用药时间较短,一般不会发生精神依赖行为。更多还原

【Abstract】 Objective:To assessment the cancer pain in children and the effect,dosage and safety of analgesics in that relieving moderate and severe pain in different age of children.Methods:Forty-six children aged3～14years with moderate and severe cancer pain were en-rolled in this study.All patients were divided into three age groups(less than3,5～7and8～14years old).The self-report,proxy-report and both combined were used to assess the site and in-tensity of pain.Based on the principle of the WHO analgesic ladder,the children with moderate pain were treated with Codeine(Galake).When the pain couldnt be controlled sustained morphine was used.For the severe pain,morphine was the first choice and the effect and side effect were observed.Results:In15patients with moderate pain,only2were relieved by Glake,and the others were relieved by MST.All children with severe pain have got pain relief by MST except two children who had dysuria were discontinued the medication.The effective rate of morphine was94.3%.The main side effects were sedation,constipation and nausea,which occurred about 36.4%,27.2%and17.9%respectively.No addiction occurred.Conclusion:1.Self-report,proxy-report and both combined should be used in different age of children to evaluate the cancer pain.2.Good effect can be achieved when adequate morphine is used in severe pain.3.No psychological dependence exists after short-term administration of these agents in children with cancer pain.更多还原