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1、·164·ALOFBASICANDCLIN1CALONCOLOGYVo1.23N0.2ADr.2010美施康定劑量滴定治療慢性癌痛的臨床觀察徐光輝,李玉,鄭義同,宋子琰,李艷(連云港市第一人民醫(yī)院腫瘤化療科,江蘇連云港222002)摘要:目的評價(jià)美施康定通過劑量滴定對慢性癌痛的治療作用。方法86例中重度慢性癌痛給予美施康定,初始劑量為30~60mg/d,觀察24~48h疼痛無緩解即進(jìn)行個(gè)體劑量滴定,根據(jù)疼痛緩解程度的不同逐漸增加劑量,直至疼痛緩解。如經(jīng)放化療后疼痛減輕而需要減量時(shí),按每2d25%~50%劑量遞減。整個(gè)治療期間隨時(shí)進(jìn)行劑量滴定,直
2、到用藥終止。結(jié)果平均初始劑量、維持劑量及最大劑量分別為40、60、80mg/d。平均用藥48.5d,最長者達(dá)435d。平均達(dá)維持量及最大劑量的天數(shù)分別為3、10d。25例不需增加初始劑量;61例需要增加劑量。疼痛緩解率為97.7%,對各種類型疼痛均有效。主要毒副反應(yīng)為便秘38例(44.2%)和惡心15例(17.4%)。86例中,治療停止的原岡分別為死亡60例(69.8%),放、化療后疼痛緩解11例(12.8%),病情進(jìn)展9例(10.5%),毒副反應(yīng)6例(7.O%)。結(jié)論美施康定可作為慢性癌痛的首選藥物,劑量個(gè)體化給藥可以更有效地控制癌痛。關(guān)鍵詞
3、:癌痛;美施康定;劑量滴定中圖分類號:R730.6文獻(xiàn)標(biāo)識碼:A文章編號: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