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目的:探讨芬太尼透皮贴剂在中、重度癌痛患者中的不良反应情况,为芬太尼透皮贴剂的临床应用提供参考。方法:伴有癌痛的晚期肿瘤病人80例根据癌痛发生的严重程度分为中度癌痛60例(对照组)和重度癌痛20例(观察组),两组都采用基于芬太尼透皮贴剂的麻醉方法。结果:两组治疗治疗期间患者持续痛强度VAS评分与治疗前的VAS评分相比差异非常显著(P<0.05)。但是观察组的VAS评分在治疗前,治疗第1、3日明显高于对照组(P<0.05),不过治疗第5天VAS均<2分,属于轻度疼痛。两组治疗后的恶心评分较治疗前有所提高,治疗第5日的恶心评分增高明显(P<0.05)。治疗后的呕吐评分与镇静评分也高于治疗前评分,但是与治疗前相比无显著性差异。两组各个时间点相比无明显差异(P<0.05)。两组经过治疗后(以治疗第5日为判断时间),观察组出现的便秘、尿潴留、乏力等不良反应明显高于对照组(P<0.05),而两组头晕、皮肤瘙痒等不良反应无明显差异。结论:芬太尼透皮贴剂在中、重度癌痛患者的镇痛效果都比较好,能有效降低恶心、呕吐、镇静的发生率,但是对于中度癌痛患者能更好的预防便秘、尿潴留、乏力的发生。
Objective: To investigate the adverse reactions of fentanyl transdermal patch in patients with moderate and severe cancer pain, and to provide a reference for the clinical application of fentanyl transdermal patch. Methods: According to the severity of cancer pain, 80 cases of advanced cancer patients with cancer pain were divided into 60 cases of moderate cancer pain (control group) and 20 cases of severe pain cancer (observation group) .Two groups were treated with fentanyl Transdermal patches for anesthesia. Results: The VAS scores of patients with sustained pain intensity during treatment were significantly different from those before treatment (P <0.05). However, the VAS score of the observation group before treatment was significantly higher than that of the control group on the 1st and 3rd days (P <0.05), but the VAS was <2 on the 5th day of treatment, which was mild pain. The scores of nausea after treatment in both groups were higher than those before treatment, and the nausea score increased significantly on the 5th day after treatment (P <0.05). Vomiting and sedation scores after treatment were also higher than pre-treatment scores, but no significant difference compared with before treatment. There was no significant difference between the two groups at all time points (P <0.05). After treatment (on the 5th day as the judgment time), adverse reactions such as constipation, urinary retention and fatigue in the observation group were significantly higher than those in the control group (P <0.05), while adverse reactions such as dizziness and pruritus occurred in both groups No significant difference. CONCLUSION: Fentanyl transdermal patches have a better analgesic effect in patients with moderate-to-severe cancer pain and can effectively reduce the incidence of nausea, vomiting and sedation. However, patients with moderate cancer pain can better prevent constipation, Urinary retention, fatigue occurred.