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目的探讨美施康定治疗晚期癌痛的临床效果。方法选择我院2007年11月至2009年11月晚期癌症者59例,均有中度或重度的癌性疼痛。根据WHO癌症三阶梯治疗的原则,本组患者均为为使用一、二级止痛药物无效或中重度以上癌性疼痛的患者,在给药过程中,注意个体化治疗,美施康定的初始剂量由疼痛程度及服药史而定,一般10～30mg开始服用,2次/d,如果患者口服困难,可改为直肠给药。患者服药后2d疼痛没有缓解,可按照25%～50%的增加幅度增加剂量。如经过放疗或者化疗而疼痛减轻患者,按照25%～50%的幅度减少剂量。结果本组患者中完全缓解30例,明显缓解27例,中度缓解1例,轻度缓解1例。疼痛缓解率为96.6%。在本组患者中出现便秘17例,恶心7例,头晕4例,呕吐患者2例,排尿困难1例,排痰困难l例。仅有1例患者难以而停药。结论美施康定能够显著抑制中重度癌痛,疼痛缓解率高,不良反应小,临床效果显著,值得借鉴。
Objective To investigate the clinical effect of Meishi Kangding in the treatment of advanced cancer pain. Methods Select 59 cases of advanced cancer in our hospital from November 2007 to November 2009, all with moderate or severe cancerous pain. According to WHO principles of three-step cancer treatment, patients in this group are for the use of primary and secondary painkillers invalid or moderate to severe cancer pain in patients with the process of drug delivery, pay attention to individualized treatment, the initial dose of Meishi Kangding By the degree of pain and medication history may be, generally 10 ~ 30mg started taking, 2 times / d, if the patient oral difficulties, can be changed to rectal administration. The patient did not relieve the pain 2d after taking medicine, according to 25% to 50% increase in the dose increase. Such as after radiotherapy or chemotherapy to reduce pain in patients, according to 25% to 50% reduction in dose. Results The complete remission in this group of 30 patients, significantly relieved in 27 cases, moderate remission in 1 case, mild remission in 1 case. The pain relief rate was 96.6%. In this group of patients appeared in 17 cases of constipation, nausea in 7 cases, 4 cases of dizziness, vomiting in 2 cases, dysuria in 1 case, expectoration difficulties l cases. Only 1 patient was difficult to stop. Conclusion Meishi Kangding can significantly inhibit moderate to severe cancer pain, pain relief rate, adverse reactions, clinical effect is significant, it is worth learning from.