盐酸羟考酮控释片治疗老年癌痛体会

目的 观察盐酸羟考酮控释片(商品名:奥施康定),治疗老年恶性肿瘤患者中、重度疼痛的临床效果及不良反应,明确该药在治疗老年癌痛中的有效性及安全性.方法 2005年3月至2009年2月中、重度疼痛老年恶性肿瘤患者(年龄≥60岁)106例,给予盐酸羟考酮控释片镇痛治疗,初始剂量10 mg/12 h,正在用吗啡类镇痛药者,按照口服吗啡1/2剂量换算,根据疼痛情况调整剂量,直至患者无痛或基本无痛,每位患者至少治疗4周以上.同时进行疼痛强度、睡眠、食欲、疲乏、精神状态、日常生活、理解配合程度评分及不良反应观察.结果 盐酸羟考酮控释片在老年癌痛患者最小有效剂量为10 mg/d,每日剂量≥200 mg的23例(21.7%),100～180 mg/d的30例(28.2%),10～90 mg/d的53例(50.0%).疼痛缓解率为97.2%,不良反应主要表现为消化道反应(便秘、恶心和呕吐),便秘较常见,需要药物干预者26例(24.53%).结论 盐酸羟考酮控释片治疗老年中、重度癌性疼痛疗效显著,耐受性良好,不良反应较少,能很好地改善老年癌症患者的生活质量.

Treatment for cancerous pain in the elderly with Oxy-Codone hydrochloride controlled-release tablets.

Objective To evaluate effectiveness and side effects, as well as its safety, of Oxy-Codone hydrochloride controlled-release tablets (Oxycontin) for the elderly patients with moderate to severe cancerous pain. Methods From March 2005 to February 2009,106 elderly patients ( aged more than 60 years) suffered from moderate to severe cancerous pain were treated with Oxycontin,at initial dose of 10 mg/12 h. For the patients using making them pain-free or pain relieved mostly. Every patient was treated for 4 weeks at least. Severity of pain,sleeping status, appetite, fatigue, mental status, daily life, scores of understanding and cooperation, and side effects were .observed.Results The minimal effective dose of Oxycontin was 10 mg/d for the elderly patients with cancerous pain. Twenty-three patients (21.7%) were treated with it at dose of ≥200 mg/d,30 patients (28. 2% )at dose of 100 - 180 mg/d,and 53 patients (50. 0% ) at dose of 10 -90 mg/d. Pain was relieved in 97. 16% of the patients after treatment, with common side effects of constipation, nausea, vomiting;and drug treatment was needed for 24. 53% (26/106) of the patients with more common constipation. Conclusions Oxycontin is effective,tolerable,less side-effects for the elderly patients with moderate to severe cancerous pain, and can improve their quality of life.