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目的评价晚期癌痛患者由口服控释吗啡转换为芬太尼透皮贴剂止痛的疗效与不良反应。方法 40例口服控释吗啡镇痛不满意的晚期癌痛患者,交替为芬太尼透皮贴剂,吗啡与芬太尼贴剂的剂量换算比为100∶1。采用0～10视觉模拟评分法评价疼痛强度,评分降低≥2表示疼痛缓解有临床显著性差异;不良反应评估分为4级:无不良反应(0)、轻度(1)、中度(2)或重度(3)。结果药物交替后疼痛强度明显降低,转换前平均疼痛评分为5.7,转换后7 d降至3.4。发生至少一种不良反应的患者转换前为37例(92.5%),转换后降至25例(62.5%)。结论将口服控释吗啡交替为芬太尼透皮贴剂是一种安全有效的镇痛策略。
Objective To evaluate the curative effect and adverse reactions of oral controlled release morphine to fentanyl transdermal patch in patients with advanced cancer pain. Methods Forty patients with advanced cancer pain who were not satisfied with morphine analgesia were treated with transdermal fentanyl patch alternately. The dose conversion ratio of morphine to fentanyl patch was 100: 1. 0 ~ 10 visual analogue scale was used to evaluate the pain intensity. The decrease of score ≥2 means that there was a clinically significant difference in pain relief. The adverse reaction was assessed as grade 4: no adverse reaction (0), mild (1), moderate ) Or severe (3). Results After the drug alternation pain intensity was significantly reduced, the average pain score before conversion was 5.7, 7 days after conversion to 3.4. The number of patients with at least one adverse reaction was 37 (92.5%) before conversion and 25 (62.5%) after conversion. Conclusion Oral oral administration of morphine alternates to fentanyl transdermal patch is a safe and effective analgesic strategy.