阿片类联合激素及抗惊厥药治疗晚期癌痛的临床观察

目的　探讨晚期癌痛应用阿片类药物的合理用药方案。方法　选择伴有中、重度疼痛的晚期肿瘤患者，分３组，第一组３６例，采用盐酸羟考酮控释片（奥施康定）单药治疗；第二组１９例，用奥施康定和甲强龙联合治疗；第三组２５例，用奥施康定联合加巴喷丁。观察３组患者治疗后的疼痛缓解情况和生活质量。结果　单用奥施康定组完全缓解率为６３.９％，奥施康定联合甲强龙组为６８.４％，奥施康定和加巴喷丁联用组为４８.０％。主要毒副反应为便秘，其次为恶心、呕吐。第二组毒副反应最轻，第三组部分患者出现头晕和嗜睡。结论　阿片类药物奥施康定治疗晚期癌痛具有较好的疗效，其中奥施康定联合甲强龙尤其适合肺癌伴脑转移或骨转移患者，且安全性高，值得临床推广。

Obseration of opioid combined with corticosteroids or anticonvulsants for advanced cancer patients with pain

Objective The study was to explore rational administration of antalgesic drugs for relieving pain,reducing side-effects and ameliorating the quality of life(QOL)in patients with advanced cancer.Methods Patients with moderate and severe pain were selected and classified into three groups: administrating oxycodone hydrochloride controlled-release tablets(oxycodone),oxycodone plus methylprednisolone,oxycodone plus gabapentin,respectively.Pain remission and the quality of life(QOL)in patients were recorded and ...