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时间:2019-05-24
《美施康定剂量滴定治疗慢性癌痛的临床观察》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、·164·ALOFBASICANDCLIN1CALONCOLOGYVo1.23N0.2ADr.2010美施康定剂量滴定治疗慢性癌痛的临床观察徐光辉,李玉,郑义同,宋子琰,李艳(连云港市第一人民医院肿瘤化疗科,江苏连云港222002)摘要:目的评价美施康定通过剂量滴定对慢性癌痛的治疗作用。方法86例中重度慢性癌痛给予美施康定,初始剂量为30~60mg/d,观察24~48h疼痛无缓解即进行个体剂量滴定,根据疼痛缓解程度的不同逐渐增加剂量,直至疼痛缓解。如经放化疗后疼痛减轻而需要减量时,按每2d25%~50%剂量递减。整个治疗期间随时进行剂量滴定,直
2、到用药终止。结果平均初始剂量、维持剂量及最大剂量分别为40、60、80mg/d。平均用药48.5d,最长者达435d。平均达维持量及最大剂量的天数分别为3、10d。25例不需增加初始剂量;61例需要增加剂量。疼痛缓解率为97.7%,对各种类型疼痛均有效。主要毒副反应为便秘38例(44.2%)和恶心15例(17.4%)。86例中,治疗停止的原冈分别为死亡60例(69.8%),放、化疗后疼痛缓解11例(12.8%),病情进展9例(10.5%),毒副反应6例(7.O%)。结论美施康定可作为慢性癌痛的首选药物,剂量个体化给药可以更有效地控制癌痛。关键词
3、:癌痛;美施康定;剂量滴定中图分类号:R730.6文献标识码:A文章编号:1673—5412(2O10)02—0164—03ClinicalObservationofMSContinwithDosageTitrationTherapvintheTreatmentofChronicCancerPainXuGuanghui,LiYu,ZhengYitong,SongZiyan,LiYan(DepartmentofChemotherapy,theFirstPeople’sHospitalofLianyungang,Lianyungang222002,
4、China)Abstract:0bjectiveToevaluatethecurativeeffectofMSeontinwithdosagetitrationtherapyinthetreatmentofchroniccancerpain.MethodsEighty—sixpatientswithmoderate-severechroniccancerpainweregivenMScontinwithdosagetitrationtherapy.ThedailyinitialdosageofMScontinstartedfrom30—60mg
5、.Ifthepainwasnotrelievedafter24-48hours.thedosagewasincreasedaccordingtothepainre—liefdegree.Ifthepainwasrelievedafterradiotherapyorchemotherapy.thedosagecouldbedecreasedto25%一50%pertwodays.Duringthetreatment,thedosagetitrationwascarriedoutwheneveritwasnecessaryunti1cessatio
6、nofmedicine.ResultsThenleandailvinitialdosage,maintenancedosageandmaximumdosagewere40mg.60mgand80mgrespectively.Themeantimeoftakingmedicinewas48.5days,andthemaximumwasupto435days.Themeantimeoftakingmaintenancedosageandmaximumdosagewere3daysand10daysre—spectively.25patientsdi
7、dnotneedtoincreasetheirdailyinitialdosage:61patientsdid.Thepainreliefratewas97.7%.MScontinwasefectiveinrelievingallkindsofpains.Thecommontoxicitieswereconstipation(44.2%)andnausea(17.4%).Amongthe86patientswhoceasedtotakethemedicine,60patients(69.8%)weredead,thepainsof11patie
8、nts(12.8%)wererelievedafterradiotherapyorchemotherapy,thesituationof9patien
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