羟考酮控释片治疗中重度癌痛72例的临床观察

目的:观察盐酸羟考酮控释片(奥施康定)治疗中重度癌痛的疗效,不良反应及患者生活质量改善情况.方法:应用羟考酮控释片治疗72例中重度癌痛患者,对其治疗疗效,不良反应,生活质量进行观察和评估.根据疼痛程度羟考酮控释片初始剂量为5mg/次或10mgg/次,每12小时一次口服.如果每日出现爆发性疼痛超过2次,则调整下次用药剂量.对于起始剂量5mg可以直接增加至10mg,对于起始剂量大于或等于10mg的患者,每次增加的剂量在原有剂量的基础上增加25%～50%.出现爆发性疼痛时用即释吗啡片解救.结果:72例中重度癌痛患者口服羟考酮控释片经过个体化滴定后最终剂量范围10～100mg/天,其中12例(16.7%)获得完全缓解,52例(72.2%)获得部分缓解,6例(8.3%)获得轻微缓解,总的疼痛缓解率88.9%.主要不良反应为便秘,恶心呕吐,头晕,嗜睡,排尿困难.全组KPS评分12例(16.7%)明显改善,20例(27.7%)有改善,40例(55.6%)达到稳定.结论:盐酸羟考酮控释片治疗中重度癌痛疗效稳定,不良反应少,耐受性良好,能显著改善患者生活质量.

Clinical study of Controlled-Release Oxycodone on moderate and severe chronic cancer pain

Objective: To observe the analgesic effect and adverse effects of Controlled-Release Oxyco-done tablets(oxycontin) on moderate and severe chronic cancer pain, and the improvement of quality of life(QOL) in the cancer patients after the treatment. Methods: A total of 72 patients with moderate and se-vere chronic cancer pain were selected .The analgesic effects,adverse effects and quality of life (QOL) were observed and evaluated. Controlled-Release Oxycodone tablets were administered at an initial dose of 5 mg or 10 mg every 12 hours according to the degree of pain. The next analgesic dose should be adjust-ed if breakthrough pain occurs more than twice in 24 hours. If the initial dose is 5 mg, it may be increased to greater than or equal to 10 mg. If the initial dose is greater than or equal to 10 mg, the dosage may increased by 25%～50%. Short-acting morphine tablets are used to control the breakthrough pain. Results: The doses ranged between 10～100mg/d .Among the 72 patients with moderate and severe chronic cancer pain, 12 (16.7%)achieved complete remission ,52(72.2%)achieved partial remission,6(8.3%) achieved minor remis-sion.The overall rate of pain relief 88.9%. The mainly adverse reactions were including, nausea and vomiting, dizziness, drowsiness and dysuria. Followed the reduced of the pain intensity ,the QOL of most cancer pa-tients was improved. The KPS of 12 patients had been obviously improved, 20 patients had mildly improved, and 40 patients were stabilized. Conclusion: Oxycodone hydrochloride controlled-release tablets are effective and safe for the management of chronic cancer patients with moderate and severe pain, with less adverse reactions, and the QOL of cancer patients were significantly improved.