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我院对晚期癌症疼痛患者采用WHO的三阶梯止痛方案,用于改善癌性疼痛。在第三阶段临床治疗中用阿片类药物,美施康定控释片口服方式给药,按时给药并根据止痛程度调整给药剂量,使70%～80%癌症疼痛得到缓解,其止痛疗效分级法(VRS)和划线法(VAS)呈明显下降趋势。然而,美施康定应用过程中消化道副作用发生率逐渐增加。其中13例因顽固恶心、吞咽困难和大便干燥等不良反应,严重妨碍该口服制剂的使用。将美施康定缓释片改为直肠给药,用药时间、剂量减少或不变的情况下可获得同等满意的镇痛效果,又无明显消化道副作用。
Our hospital uses the WHO’s three-step analgesic regimen for advanced cancer pain patients to improve cancer pain. In the third phase of clinical treatment with opioid drugs, the United States Shi Kangding controlled release tablets oral administration, timely administration and adjust the dose according to the degree of pain, so that 70% to 80% of cancer pain is relieved, the analgesic efficacy classification VRS and VAS showed a significant downward trend. However, the incidence of side effects of digestive tract during the application of metstaining gradually increased. Thirteen of these patients were severely hampered by the use of oral preparations because of adverse reactions such as persistent nausea, dysphagia, and dry stools. The Meschconol Sustained-release Tablets was changed to rectal administration, and the same satisfactory analgesic effect was obtained with reduced dose or the same dose, and no obvious gastrointestinal side effects.