摘要
背景与目的:造血干细胞移植相关性口腔粘膜损伤的发生率较高,由于严重口腔粘膜炎、溃疡合并疼痛,明显地降低患者的生活质量。芬太尼透皮贴剂主要用于治疗肿瘤慢性疼痛,疗效确切,对肿瘤治疗相关的严重粘膜炎导致的疼痛亦有疗效。本研究主要探讨芬太尼透皮贴剂治疗造血干细胞移植相关性口腔粘膜炎疼痛的镇痛疗效及安全性。方法:接受大剂量化疗联合自体造血干细胞移植后出现口腔粘膜炎伴疼痛的恶性肿瘤患者共22例,治疗前后的疼痛评分采用直观模拟标度尺评分法(visual analogue scale,VAS)计为0～10分,入组前疼痛状况评估均为中-重度疼痛(VAS≥4分)。采用我国于1990年制定的生活质量标准评估治疗前后的生活质量,同时根据美国国立癌症研究所通用毒副作用评分标准评估治疗相关的不良反应。结果:治疗前VAS中位评分为6分(4～9分),治疗后第3、5、7、10、15天的VAS中位评分降至3.5分(0～9分)、2分(0～6分)、0.5分(0～8分)、0分(0～6分)、0分(0～5分),治疗后疼痛程度均显著减轻(P<0.001),总有效率100%,完全控制率45.5%。治疗后患者生活质量明显改善(P<0.01)。芬太尼的不良反应多为头晕不适、嗜睡、排尿困难、轻度恶心、呕吐、胃部不适等,经处理均能缓解。未发现严重危及生命的不良反应和停药后药物依赖现象。结论:芬太尼透皮贴剂治疗造血干细胞移植相关性口腔粘膜炎疼痛镇痛效果良好,且副作用轻微、使用方便、能显著改善患者的生活质量。
BACKGROUND ＆ OBJECTIVE： The incidence of mucositis caused by autologous hematopoietic stem cell transplantation （AHSCT） is relatively high. The severe painful mucositis can reduce the quality of life of patients obviously. Transdermal fentanyl is efficient in treating chronic pain of cancer, and also can relieve the severe pain of mucositis resulted from chemotherapy. This study was to investigate the efficacy and safety of transdermal fentanyl for the severe painful mucositis caused by AHSCT. METHODS： A total of 22 malignant tumor patients suffered from severe mucositis caused by high dose chemotherapy combined AHSCT. The analgesic degree before and after treatment was evaluated by the scores of Visual Analogue Scale （VAS） （range 0-10）. The median VAS scores of all patients were above 4 （moderate to severe pain） before the administration of transdermal fentanyl. The quality of life before and after treatment was evaluated by the Standard of Quality of Life drew up in China in 1990. The adverse events after treatment were evaluated by Common Toxicity Criteria formulated by National Cancer Institute of the USA. RESULTS： The median VAS score has been decreased from baseline at 6 （4-9） to 3.5 （0-9） on Day 3, 2 （0-6） on Day 5, 0.5 （0-8） on Day 7, 0 （0-6） on Day 10, and 0 （0-5） on Day 15 after treatment （P〈0.001）. The overall response rate was 100%, while the complete response rate was 45.5%. The quality of life of the patients was improved significantly （P〈0.01）. The adverse events after treatment of transdermal fentanyl included dizziness, somnolence, dysuria, mild and transient nausea, vomiting, discomfort of stomach, and so on. All the adverse events disappeared within several days after proper managements. Neither severe adverse event nor drug addiction was found. CONCLUSIONS： Transdermal fentanyl has good analgesic effect on painful severe mucositis induced by AHSCT. It is convenient and well tolerated, and could improve quality of life significantly.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2007年第4期390-393,共4页
Chinese Journal of Cancer
关键词
芬太尼透皮贴剂
造血干细胞移植
口腔粘膜炎
非癌性疼痛
生活质量
Transdermal fentanyl
Autologous hematopoietic stem cell transplantation
Mucositis
Non-cancerous pain
Quality of life
作者简介
通讯作者：黄慧强,Tel： 86-20-87343350 E-mail： huang_sysu@ 163.com
