放疗配合盐酸羟考酮控释片治疗47例骨转移癌中重度疼痛的临床观察.docVIP

放疗配合盐酸羟考酮控释片治疗47例骨转移癌中重度疼痛的临床观察 ［ ］目的探讨常规放射治疗配合盐酸羟考 酮控释片（奥施康定）对恶性肿瘤骨转移的姑息性止 痛治疗效果，减轻疼痛，提高患者的生存质量。方法 47例骨转移癌中重度疼痛患者，放疗配合口服药物， 共治疗观察5周。第1周，单独口服盐酸羟考酮控释 片（奥施康定），起始剂量10mg，每12小时1次，根 据疼痛情况调整用量。第2周开始常规放疗（DT2Gy/ 次，5次/周，总剂量DT40Gy/20f）配合口服药物。观 察给药后 0.5h、lh、12h、24h、72h、每周末（DTOGy、 DT 10Gy/5f、DT 20 Gy/lOf、DT 30Gy/15f、DT 40Gy/20f） 以及第3、5周末（放疗剂量至DT20Gy/10f、DT40Gy/20f） 暂停应用盐酸羟考酮控释片24h后VAS、KPS评分及 不良反应情况，计算中度以上疼痛缓解率。结果第 1周内单独应用盐酸羟考酮控释片，中度以上缓解率 达95.7% （45/47）；第2周、第3周、第4周末，中 度以上疼痛缓解率均在91.5%以上，疼痛控制满意， 可部分停药或减少药物应用及相关不良反应；放疗结 束（停药）后止痛总有效率91.5% （43/47）;整个配 合治疗过程中，患者疼痛控制满意，生存质量改善明 显。结论放疗配合盐酸羟考酮控释片治疗对骨转移 癌中重度疼痛控制效果好，标本兼治，疗效长短结合， 无严重不良反应，是一种安全、有效的止痛治疗组合 方法。 ［关键词］放射治疗；盐酸羟考酮控释片(奥施康 定)；骨转移癌；中重度疼痛 ［ ］R738.1 ［ ］A ［ ］ 2095-0616 (2015) 01-27-05 ［Abstract］ Objective To evaluate the curing efficacy of radiotherapy combined with controlled-release oxycodone hydrochloride tablets (oxycontin) in malignant tumor with skeletal metastases, relieve pain， improve the quality of life of patients. Methods A total of 47 patients suffering from moderate- severe pain caused by skeletal metastases carcinoma，combined radiotherapy with oral drugs for 5weeks.ln the first week, controlled-release oxycodone hydrochloride tablets (oxycontin) alone were taken orally at an initial dose of lOmg q 12h and the dosage was adjusted according to the pain. The second week， conventional radiotherapy (DT 2Gy/f，5f/W) was done and continued to medications (oxycontin) taken continued. VAS, KPS score, and adverse reactions were observed within 1 week (0.5h、lh、12h、24h、72h)，and every weekend (DTOGy，DT 10Gy/5f，20Gy/10f, DT 30Gy/15f，DT 40Gy/20f) . Observed the VAS, KPS score， and the same index was observed at the end of the third and 5th week (DT 20Gy/10f，DT40Gy/20f) withdrawal controlled-release oxycodone hydrochloride tablets 24hours later. Figured the pain relief rate (moderate or above) ? Results The first weeks， application of controlled-release oxycodone hydrochloride tablets (oxycontin) alone, remission rate of moderate or above w