芬太尼透皮贴剂在癌性腹水患者慢性持续性中重度腹痛中的应用

目的：观察芬太尼透皮贴剂对晚期癌症伴癌性腹水致慢性持续性中重度疼痛患者的镇痛效果及安全性。方法：通过开放、自身对照研究,对我院晚期癌症伴癌性腹水致慢性持续性中重度疼痛患者45例（采用自行评分法如NRS评分≥6）,给予多瑞吉以小剂量25μg/h开始,贴于前胸腹壁,每3天更换贴剂,并酌情调整剂量。记录治疗前后的疼痛强度、生活质量和不良反应。结果：45例癌性腹水致慢性持续性中重度疼痛患者,7天后评价腹部胀痛缓解,显效率84.4%,总有效率97.8%,NRS评分由使用前7.4±0.55下降至第7日的2.8±0.44;4周观察期结束时,患者疼痛控制总有效率（显效和有效）为68.9%。不良反应有嗜睡、便秘、头晕、恶心呕吐等,无危及生命的严重不良反应出现。患者的生活质量得到明显改善。结论：芬太尼透皮贴剂对于癌性腹水伴有中重度癌痛的多数患者止痛疗效满意,不良反应轻微,能明显改善癌症患者的生活质量,值得推荐使用。

A clinical study on the efficacy and side effects of duragesic in 45 patients with malignant ascitic fluid suffered persistent moderate to severe cancer pain

Objective： To evaluate the efficacy and adverse effects of duragesic in management of patients with malignant ascitic fluid suffered moderate to severe cancer pain.Methods： The study was an open-label,self-controlled study.A NRS score standard was applied.All 45 patients（NRS ≥6） were administered duragesic,begin with a dose of 25μg/h.The paitients＇pain severity,quality of life and side effects were recorded.Results： Baseline mean of pain intensity was 7.4 ± 0.55,at the 7th day was 2.8 ± 0.44.There was a significant difference（P 0.05）.The CR was 84.4%,and OR was 97.8%.The common side effects were constipation,nausea,dizziness,vomiting and sedation.Most of the side effects were tolerable.Furthermore,the quality of life was significantly improved after treatment with duragesic.Conclusion： Duragesic for patients with moderate to severe cancer pain is effective,safe and convenient,and can improve the quality of life.It can be recommended as one of first-line drugs for the treatment of patients with malignant ascitic fluid suffered persistent moderate to severe cancer pain.