论文部分内容阅读
目的力求癌痛治疗效果与安全性的统一。方法按三级阶梯止痛疗法的用药原则：①实行“目标”（无痛）治疗，不计较用药剂量；②预防大剂量止痛药物的副反应；③效果评价标准兼顾“缓解程度”和“生存质量”的统一。结果90例中、重度癌痛患者中，完全缓解达67％，中度缓解达29％，显著有效率（完全缓解＋中度缓解）为96％；癌痛综合征逐步消除；生存质量分值由治疗前平均29分．三天后升至42分；哌替啶过量所致呼吸抑制即时恢复。结论①三级阶梯止痛疗法仅为指导原则，具体病人还需在用药量和安全性之间摸索“最佳交叉点”；②医源性痛苦（不一定疼痛）、癌痛综合征和癌痛三者需同步处理；③逐步用“生存质量”标准取代“缓解程度”，可使癌痛治疗效果有质的提高。
Objective To strive for the unification of cancer pain treatment effectiveness and safety. Methods According to the principle of three-step analgesic medication: 1 “target” (painless) treatment, do not care about the dose; 2 side effects of prevention of large-dose analgesic drugs; 3 effect evaluation criteria taking into account “remission” and “quality of life ”Unification. Results Among 90 moderate and severe cancer pain patients, complete remission was 67%, moderate remission was 29%, significant effective rate (complete remission + moderate remission) was 96%; cancer pain syndrome was gradually eliminated; quality of life score An average of 29 points before treatment. After 3 days, it rose to 42 points; respiratory depression caused by pethidine was restored immediately. Conclusion 1 The three-step analgesic therapy is only a guiding principle, and specific patients need to explore the “best point of intersection” between the amount of medication and safety; 2 iatrogenic pain (not necessarily pain), cancer pain syndrome, and cancer pain The three need to be handled synchronously; 3 gradually replace the “degree of remission” with the “quality of life” standard, so that the treatment effect of cancer pain can be qualitatively improved.