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目的:观察盐酸羟考酮控释片(奥施康定)治疗中、重度癌痛的临床效果、不良反应。方法:48例中、重度疼痛患者给予奥施康定镇痛治疗,初始剂量10mg/12h,正在用吗啡类镇痛药者,按照吗啡1/2剂量换算。根据疼痛情况调整剂量,直至患者无痛或基本无痛,每位患者至少治疗2周以上,同时进行疼痛强度、生活质量评价和不良反应观察。结果:48例癌痛患者治疗后明显缓解和中度缓解的44例(91.7%),轻度缓解的3例(6.2%),无效1例(2.1%),有效镇痛剂量在20～120mg/天,其中需要调整剂量者有22例(45.8%),33例(68.8%)在首次用药后24小时内能观察到疼痛的改善,40例(83.3%)在用药后7天达到稳定的镇痛效果,34例(70.8%)患者在治疗后的Karnofsky评分有不同程度的提高,不良反应主要有便秘14例(29.2%),恶心呕吐8例(16.7%),头晕3例(6.3%),乏力4例(8.3%),嗜睡1例(2.1%),口干2例(4.6%),均为轻、中度反应。结论:盐酸羟考酮控释片治疗中、重度癌性疼痛疗效显著,能明显改善癌痛患者的生活质量,不良反应较少,使用简单、方便。
Objective: To observe the clinical effects and adverse reactions of oxycodone hydrochloride controlled-release tablets (OxyContin) in the treatment of moderate and severe cancer pain. Methods: 48 patients with moderate to severe pain were given oxocorticine for analgesia. The initial dose was 10mg / 12h. Morphine analgesics were being used and the dosage was converted to morphine 1/2. Adjust the dose according to the pain, until the patient is painless or almost painless, and each patient is treated for at least 2 weeks. Pain intensity, quality of life, and adverse reactions are also observed. Results: Forty-four cases (91.7%) were relieved and moderately relieved in 48 patients with cancer pain. Three patients (6.2%) were relieved mildly and one patient (2.1%) was ineffective. The effective analgesic dose was 20 ~ 120mg / Day, of which 22 (45.8%) were required to adjust the dose, 33 (68.8%) had improvement in pain within 24 hours after the first dose and 40 (83.3%) were stable 7 days after treatment The Karnofsky scores of 34 patients (70.8%) were improved to some extent after treatment. The main adverse reactions were constipation in 14 patients (29.2%), nausea and vomiting in 8 patients (16.7%), dizziness in 3 patients (6.3% ), Fatigue in 4 cases (8.3%), drowsiness in 1 case (2.1%) and dry mouth in 2 cases (4.6%). All of them were mild and moderate reactions. Conclusion: Oxycodone hydrochloride controlled-release tablets in the treatment of moderate and severe cancerous pain significant effect, can significantly improve the quality of life of patients with cancer pain, fewer adverse reactions, the use of simple and convenient.