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我院芬太尼透皮贴剂在癌痛治疗中的使用分析
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| 篇名： | 我院芬太尼透皮贴剂在癌痛治疗中的使用分析 |
| TITLE： | |
| 摘要： | 目的：为促进芬太尼透皮贴剂的临床合理使用提供参考。方法：利用医院信息系统及数字化病历管理系统调取数据，抽取我院2014年6－12月使用芬太尼透皮贴剂治疗癌痛的150份住院患者病历，进行回顾性调查和分析。结果：150例使用芬太尼透皮贴剂治疗癌痛的患者中，疼痛强度数字评分法（NRS）评分为1～3、4～6、7～10分的患者分别有17例（11.3％）、63例（42.0％）、5例（3.3％），其余患者未进行疼痛强度评分；88例为阿片类药物耐受患者，62例为阿片类药物未耐受患者，使用芬太尼透皮贴剂的主要原因是患者不能口服或不能承受口服阿片类药物的副作用、肝肾功能不全等，有25例患者选用芬太尼透皮贴剂无明确原因；联合用药方面，22例患者合用盐酸吗啡注射液治疗爆发痛，12例患者合用盐酸布桂嗪注射液治疗爆发痛，8例患者合用硫酸吗啡片治疗爆发痛，10例患者合用盐酸羟考酮缓释片、硫酸吗啡缓释片等长效阿片类药物，8例患者合用氨酚羟考酮片，3例患者合用卡马西平片。结论：芬太尼透皮贴剂在我院癌痛患者治疗中的使用较为广泛，但在其使用过程中也存在一些不合理的情况，如使用前未进行疼痛强度评分，无使用透皮贴剂的用药指征，联合用药不合理等。为此医师应严格把握用药指征，临床药师应加强与医师的沟通配合，注重针对患者的用药教育，以保证其用药的合理性。 |
| ABSTRACT： | OBJECTIVE： To provide reference for rational use of Fentanyl transdermal patch in the clinic. METHODS： By extracting data from hospital information system and digital medical record management system， medical records of 150 cancer pain inpatients receiving Fentanyl transdermal patch were collected from our hospital during Jun.-Dec. 2014， and then investigated and analyzed retrospectively. RESULTS： Numeric rating scale （NRS） score of 150 cancer pain patients receiving Fentanyl transdermal patch were as follows： pain scores of 17 patients （11.3％） were 1-3 points， those of 63 patients （42.0％） were 4-6 points and those of 5 patients （3.3％）were 7-10 points； the rest of the patients were not rated. Among those 150 cases， 88 cases were well tolerated with opioid and 62 patients were considered to be opioid intolerant. Those intolerant patients were who could not be treated orally or could not bore side effects of opioid hepatic or renal dysfunction. 25 cases used Fentanyl transdermal patch without definite evidence. As to drug combination， 22 cases additionally received Morphine hydrochloride injection； 12 cases additionally received Bucinnazine hydrochloride injection； 8 cases additionally received Morphine tablet； 10 cases additionally received Oxycodone hydrochloride sustained-release tablets and Morphine hydrochloride sustained-release tablets； 8 cases additionally received Oxycodone and acetaminophen tablets； 3 cases additionally received Carbamazepine tablets. CONCLUSIONS： Fentanyl transdermal patch are widely used for cancer pain treatment in our hospital. There still is irrational use of it， such as absence of pain score before use， no medication indication， irrational drug combination. Physicians should obey medication indication strictly， and clinical pharmacists should strengthen communication with physicians and pay attention to medication education for patients so as to guarantee rational drug use. |
| 期刊： | 2017年第28卷第9期 |
| 作者： | 张雪霁，曹舫 |
| AUTHORS： | ZHANG Xueji，CAO Fang |
| 关键字： | 芬太尼透皮贴剂；癌痛；合理使用 |
| KEYWORDS： | Fentanyl transdermal patch； Cancer pain； Rational use |
| 阅读数： | 560 次 |
| 本月下载数： | 8 次 |
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