羟考酮控释片治疗中重度肺癌疼痛的临床观察

目的：观察盐酸羟考酮控释片（奥施康定）治疗中重度肺癌疼痛的疗效,不良反应及患者生活质量改善情况,同时观察不同心理状态对疼痛程度和镇痛疗效的影响.方法：应用盐酸羟考酮控释片治疗76例中重度肺癌疼痛患者,盐酸羟考酮控释片起始剂量5mg/12h或10mg/12h,根据疼痛缓解程度调整剂量,直至达到满意镇痛效果,对其镇痛疗效,不良反应进行观察和评估.采用生活质量量表EORTCQLQ-C30（V3.0）中文版对肺癌疼痛患者镇痛治疗前后的生活质量进行评估.观察不同心理状态对疼痛强度和镇痛效果的影响.结果：入组的76例患者中,有74例可评价疗效和安全性,其中67例（90.5%）达到满意的疼痛缓解,平均达有效维持剂量时间为2.4天.消极悲观者疼痛程度重、镇痛效果差,积极乐观者疼痛程度轻、镇痛效果佳.主要不良反应为便秘、恶心呕吐、头晕、排尿困难、嗜睡.在疼痛缓解的同时,肺癌疼痛患者的生活质量得到了明显改善.结论：心理状态与疼痛程度和镇痛疗效密切相关;盐酸羟考酮控释片治疗中重度肺癌疼痛安全有效,能明显改善肺癌疼痛患者的生活质量.

Clinical observation of Oxycodone controlled-release tablets in the treatment for moderate or severe pain of lung cancer

Objective：To evaluate the efficacy, adverse reactions and the improvement of quality of life （QOL） of oxycodone hydrochloride controlled - release tablets （ MS Contin Austria） in patients with lung cancer pain, and to observe the effects of different psychological effect on pain intensity and analgesic effects. Methods： Oxycodone hydro- chloride controlled - release tablet was used in treatment of 76 lung cancer cases with moderate and severe pain, oxycodone hydrochloride ontrolled -release tablets starting dose was 5mg/12h or 10mg/12h, adjust the dose according to the degree of pain relief, until a satisfactory analgesic effect. QOL was assessed in 66 lung cancer patients, using EORTC QLQ - c30. Results： Of 76 patients enrolled,74 patients were evaluable of which 67 cases （90.5%） a- chieved satisfactory pain relief. The main adverse reactions were constipation, nausea, vomiting, dizziness, drowsiness, difficulty urinating, the quality of life was improved significantly. Conclusion：Psychological status , degree of pain and analgesic efficacy is closely related; oxycodone hydrochloride controlled - release tablet treatment for moderate or severe cancer pain is safe and effective;it markedly improves the quality of life in patients with lung cancer.