芬太尼透皮贴剂治疗癌性腹胀患者的疗效观察

目的:探讨癌性腹胀患者应用芬太尼透皮贴剂的疗效与安全性。方法:对67例晚期肿瘤伴随癌性腹胀患者应用芬太尼透皮贴剂进行治疗并观察2周,期间根据腹胀缓解情况调整用药剂量。采用0~10数字评分法(numerical rating scale,NRS)评价腹胀程度,不良反应参照美国国家癌症研究所制定的不良反应事件分级标准(CTCAE4.0)进行评估。结果:应用芬太尼贴剂后患者腹胀明显缓解,平均NRS评分由治疗前7.28分降至治疗后3.59分,其中3例完全缓解,治疗前后临床差异有统计学意义(P<0.001)。芬太尼贴剂相关不良反应以恶心、头晕、嗜睡、便秘为常见,经对症处理或单纯观察后大部分可缓解,总体耐受性较好。结论:晚期肿瘤合并癌性腹胀患者应用芬太尼贴剂后腹胀症状缓解明显,生活质量改善,痛苦减轻且副作用较轻,是解决晚期癌症患者顽固性癌性腹胀的较为理想的方法。

Clinical observation of transdermal fentanyl for patients with cancer relat-ed abdominal distension

Objective:To evaluate the efficacy and safety of transdermal fentanyl for patients with cancer related abdominal dis-tension.Methods:A total of 67 cancer patients in advanced stage with cancer related abdominal distension were treated with transder-mal fentanyl for two weeks,while the drug dosages were titrated upwards according to the extent of pain relief.Evaluated outcomes in-cluded the degree of abdominal distention(by Numerical Rating Scale,NRS)and side effect(by Common Terminology Criteria for Ad-verse Events,CTCAE Version 4.0).Results:Abdominal distension was well controlled after administration of transdermal fentanyl.The mean scores decreased from 7.28 to 3.59 due to the treatment,which showed significant differences (P <0.001 ).The adverse drug re-actions were well tolerated.Common side effects were nausea,dizziness,sedation and constipation.These symptoms were relieved or e-liminated after symptomatic treatment or observation only.Conclusion:Transdermal fentanyl is effective in relieving abdominal disten-sion of patients with advanced tumor,and can significantly improve the quality of life,with a low incidence of adverse reactions.Trans-dermal fentanyl can be recommended as an ideal drug for the patients with intractable cancer related abdominal distension.