基层医院老年癌症患者三阶梯止痛治疗156例分析

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1、基层医院老年癌症患者三阶梯止痛治疗156例分析摘要目的：观察基层医院老年癌痛患者三阶梯止痛治疗的效果与不良反应，为基层医院普及癌痛三令A梯治疗提供可靠依据。方法：选择2012年3月一2016年10月老年癌痛患者156例，按癌痛三阶梯治疗原则给予止痛治疗，轻度疼痛者给予塞来昔布胶囊20mg/12h,睡前加或不加地西泮口服，中度疼痛者在轻度疼痛给药基础上加用盐酸曲马多缓释片100mg/12h,重度疼痛者在轻度疼痛给药基础上加用吗啡10mg/4h滴定，直至患者无痛后，按照阿片类药物剂量转换原则，给予硫酸吗啡控释片或多瑞吉透皮贴剂。结果：156例患者中，150例止痛有效，总有效率为96%，

2、其中轻度疼痛止痛有效为5/5,中度疼痛为98%，重度疼痛为95%。不良反应均较轻，其中便秘42例，恶心呕吐16例，头晕6例，尿潴留2例，嗜睡3例，无精神依赖患者出现。结论：三阶梯止痛法安全有效，应在基层医院老年癌痛患者止痛治疗中大力推广。关键词癌痛；止痛治疗；基层医院；老年患者；不良反应中图分类号：R979.1文献标志码：A文章编号:1006-153312-0024-03Analysisof156elderlypatientswithcancertreatedwiththree-stepanalgesictreatmentingrassroothospitalLIMing1，HAN

3、Kun2ABSTRACTObjective：Toobservetheeffectandadversereactionsofthree-stepanalgesictreatmentintheelderlypatientswithcancerpainingrassroothospitaltoprovideareliablebasisforthecancerpainthree-stepanalgesictreatment.Methods:FromMarch2012toOctober2016，156casesofelderlycancerpainwereselectedandaccordi

4、ngtotheprincipleofthree-stepanalgesictreatmentofcancerpaintogivethetreatmentofpain,mildpainwasgivencelecoxibcapsules20mg/12h，andbeforegoingtobedoraladministrationofdiazepamwasaddedornotadded.Onthebasisofmildpainadministration，moderatepainwasaddedtotramadolhydrochloridesustainedreleasetablets10

5、0mg/12h，andseverepainwasaddedwithmorphine10mg/4htitration,anduntilthepatientpainless，inaccordancewiththeopioiddoseconversionprinciple,morphinesulfatecontrolledreleasetabletsordurogesictransdermalpatchweregiven.Results：Ofthe156patients,150caseswereeffectiveinpainreliefandthetotaleffectiveratewa

6、s96%,amongthem，analgesiceffectsofmildpain,moderatepainandseverepainwere5/5，98%and95%.Adversereactionsweremild，includingconstipationin42cases，nauseaandvomitingin16cases，dizzinessin6cases，urinaryretentionin2casesandlethargyin3cases，andnopatientswithmentaldependence.Conclusion：Three-stepanalgesic

7、methodissafeandeffectiveandshouldbepromotedintheelderlypatientswithcancerpainingrassroothospital.KEYWORDScancerpain；analgesictreatment:grassroothospital；elderlypatient；adversereaction近年来，我国人口老龄化的趋势越来越明显，老年肿瘤患者也日益增加。老年肿瘤患者确诊时多已处于中晚期，具有合并