癌症爆发痛的现状和研究进展-tumor-肿瘤.PDF

1046 　　肿瘤2011 年11 月第31 卷第11 期　TUM OR Vol. 31, November, 2011 DOI: 10.3781/j .issn.1000-7431.2011.11.016 Copyright© 2011 by TUM OR 综述·Review 癌症爆发痛的现状和研究进展 李　华，刘　巍 河北医科大学第四医院肿瘤内科，石家庄　050011 [摘要]　虽然癌症患者的基础疼痛控制相当稳定，但也可能会遭受短暂的疼痛加重，即癌症爆发痛。典型的爆发 痛有快速发作和持续时间短等临床特征，这种疼痛对患者生活质量和卫生资源的不 良影响显而易见。即释型 口服 阿片类药物 目前已广泛用于爆发痛的治疗，但其起效时间及作用持续时间长的特点并不适合治疗大部分的爆发痛。 相比之下一些芬太尼制剂，如芬太尼透黏膜 口含剂 (oral transmucosal fentanyl citrate ，OTFC) 、芬太尼 口腔泡腾片 (fentanyl buccal tablet ，FBT ) 、芬太尼舌下含片 （sublingual fentanyl citrate ，SLF ）和芬太尼鼻喷雾剂 （intranasal fentanyl spray ，INFS ）等，为癌症爆发痛的治疗带来了令人欣慰的疗效。另外，国内对布托啡诺鼻喷剂治疗癌症 爆发痛也已有一定的研究。 [关键词]　肿瘤；爆发痛；类阿片 [中图分类号]　 R730.2 ；R441.1 [文献标志码] A [文章编号]　1000-7431 (2011) 11-1046-04 Current research and advances in cancer breakthrough pain LI Hua, LIU Wei Department of Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang　050011, China [A BSTRACT]　Although the control of background pain is satisfying, the patients may also suffer from transient exacerbation of pain, which is known as cancer breakthrough pain (BTP) . A typical episode of BTP has a fast onset and a short duration. The BTP can apparently affect the quality of life and may also have an adverse impact on healthcare resources. Normal-release oral opioids have been applied in the treatment of cancer BTP, but the late onset and long duration of action of oral opioids may not appropriate for controlling a typical cancer BTP. Some formulations of fentanyl provide more favourable efficacy in the control of cancer BTP, such as oral transmucosal fentanyl citrate (OTFC), buccal fentanyl citrate (FBT), sublingual fentanyl citrate (SLF), and intranasal fentanyl spray (INFS). In addition, some studies have focused on the treatment of cancer BTP with tr