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目的 :评价三阶梯止痛与姑息治疗对晚期胰腺癌的治疗作用。方法 :采用消炎痛25～50mg、每8小时服一次 ,强痛定30～90mg、每6小时服一次 ,吗啡控释片30～90mg、每12小时服一次组成三阶梯止痛方案 ,分别对轻、中、重度18例晚期胰腺癌患者进行镇痛治疗。同时行姑息治疗 ,包括心理、抗癌中成药、免疫及支持治疗。在本组患者中 ,10例采用姑息化疗 ,其中4例用顺铂20mg,甲酰四氢叶酸钙200mg,5 氟脲嘧啶500mg,连用5天 ,四周重复 ;3例用羟基喜树碱10mg,连用10天 ,4周重复。3例用氟铁龙200mg每日4次 ,连用21天 ,停7天重复。结果 :全组止痛有效率94.4% ,完全缓解率为50% ;10例化疗患者 ,1例获部分缓解 ,缓解率为10 % ;化疗组的中位生存期为4个月 ,未化疗组为2个月。止痛与化疗药物的毒性反应主要是消化道反应。止痛与姑息治疗后15人生活质量提高了一个等级。结论 :止痛与姑息治疗对晚期胰腺癌患者有减轻痛苦 ,改善生活质量的效果
Objective: To evaluate the therapeutic effects of three-step analgesia and palliative treatment on advanced pancreatic cancer. Method: Indomethacin 25～50mg, once every 8 hours, strong pain 30～90mg, once every 6 hours, morphine controlled release tablets 30～90mg, once every 12 hours to form a three-step analgesic program, respectively 18 patients with advanced pancreatic cancer were treated with analgesia. At the same time palliative care, including psychotherapy, anti-cancer proprietary Chinese medicines, immunization and supportive care. In this group of patients, 10 patients were treated with palliative chemotherapy, 4 of them were treated with cisplatin 20 mg, 200 mg of leucovorin 200 mg, 5 fluorouracil 500 mg for 5 days and repeated for 4 weeks; 3 of them were hydroxycamptothecin 10 mg. Use 10 days in a row and repeat in 4 weeks. In three cases, tetrafluralone 200 mg was used 4 times a day for 21 days and repeated for 7 days. Results: The total effective rate of analgesia was 94.4%, and the complete remission rate was 50%. In 10 patients with chemotherapy, partial remission was achieved in 1 patient with a remission rate of 10%. The median survival time was 4 months in the chemotherapy group. 2 months. The toxicity of analgesic and chemotherapeutic drugs is mainly gastrointestinal reactions. The quality of life of 15 people after analgesia and palliative care was improved by one grade. Conclusion : Pain relief and palliative treatment can relieve pain and improve quality of life in patients with advanced pancreatic cancer