恶性肿瘤患者临终前的阿片类药物止痛回顾

目的:调查恶性肿瘤患者临终前的阿片类药物止痛治疗现状。方法:分析242例患者阿片类药物止痛的基本情况,比较不同性别、年龄及肿瘤原发灶的阿片止痛情况。结果:176例(72.73%)用阿片止痛,其中134例(76.14%)用美施康定,28例(15.91%)用多瑞吉,14例(7.95%)用弱阿片,无阿片过量引起的死亡。日平均吗啡口服剂量:男性(166.67mg)明显高于女性(107.66mg),年龄增大,用量逐渐减小,但无显著差异,不同原发灶的患者无显著差异。结论:止痛治疗合理、安全;男性止痛所需阿片量比女性大,年龄大的患者阿片用量较小,肿瘤原发灶与阿片止痛剂量无关。

A Retrospective Study on Opioid Management for Cancer Patients in Extrimis

Objective: To investigate opioid analgesic management for cancer patients in extrimis. Methods: A retrospective survey was conducted to analyze cancer pain management in 242 patients with terminal cancer and to compare opioids application between different groups according to the age, gender and primary site of tumor. Results: Among all cases, 176(72.73%) received opioid therapy. In these patients, 134 (76.14%) took MS-Contin and 28 (15.91%) accepted transdermal fentanyl. Furthermore, weak opioids were taken by 14 (7.95%) patients. No patient was died of opioid usage. There was a significant increase in the total daily mean oral morphine equivalent in male patients, compared to female patients (166.67mg vs. 107.66mg). The older the patients were, the lower dose they needed to alleviate their pain, but there is no significant difference between the groups when compared with daily mean morphine doses. No correlation of primary tumor sites and opioid doses was found. Conclusions: The analgesic management of the terminal cancer patients is reasonable and safe. The males require more morphine than females to achieve similar pain relief. Elderly patients tend to alleviate cancer pain with lower dose and primary foci of tumor was not associated with opioid dose.