摘要
目的总结56例疼痛剂量滴定治疗晚期癌痛患者的依从性及药物不良反应的护理。方法共纳入2014年1月至2015年3月间本院收治的中、重度癌痛患者56例,所有患者均接受盐酸吗啡即释片剂量滴定,根据疼痛缓解程度调整剂量,滴定完成后转换成长效阿片类止痛药,以数字分级法(Numerical rating scale,NRS)和疼痛程度分级法(Verbal rating scale,VRS)评价疗效。CTC4.0毒性评价标准评价治疗不良反应。结果 56例中、重度癌痛患者中1例患者因依从性差拒绝疼痛规范化治疗,55例患者经个体化疼痛剂量滴定后转换成长效止痛药盐酸羟考酮缓释片或硫酸吗啡控释片口服,NRS评分或VRS评分由滴定前4-10分,下降至0-3分。治疗中观察到的不良反应有:便秘41例、口干11例、恶心5例、呕吐3例、头晕4例、嗜睡3例、呼吸抑制2例、尿潴留1例。经积极临床干预及护理和宣教,55例患者中10例患者便秘仍存在,其他症状均缓解,未见因不良反应中止治疗者。结论癌痛患者接受盐酸吗啡即释片个体化滴定治疗过程中,护士具备处理癌痛的技巧及能力,通过规范化的管理可以快速控制疼痛从而提高患者的生活质量。
Objective To summarize compliance 56 advanced cancer pain patients treated with dosage titration and nursing of these patients in the circumstances of adverse drug reactions. Methods 56 patients with moderate or severe cancer pain treated in our hospital from January 2014 to March 2015 were enrolled. All patients received dosage titration with morphine hydrochloride immediate release tablets, with the dosage adjusted according to the degree of pain relief. After the dosage titration, the patients received long-acting opioid analgesics. The efficacy was evaluated with numerical rating scale（NRS） and verbal rating scale（VRS）. CTC4.0 toxicity evaluation criteria were adopted to evaluate adverse reactions of treatment. Results Among the 56 patients with moderate or severe cancer pain, 1 patient refused standardized pain treatment due to poor compliance, and 55 patients received long-acting pain painkiller oxycodone hydrochloride sustained-release tablets or oral morphine sulfate controlled-release tablets after pain treatment with individualized dosage titration, and their NRS score and VRS score dropped from 4-10 points to 0-3 points. Adverse reactions observed during the treatment include： 41 cases of constipation, 11 cases of dry mouth, 5 cases of nausea, 3 cases of vomiting, 4 cases of dizziness, 3 cases of drowsiness, 2 cases of respiratory depression, and 1 case of urinary retention. After aggressive clinical intervention, nursing and education, 10 out of 55 patients were still suffering from constipation, while other symptoms were relieved. No patient was withdrawn from treatment due to adverse reactions. Conclusion During the treatment of cancer pain patients with individualized titration with morphine hydrochloride immediate release tablets, nurses showed the skills and ability to deal with cancer pain. The pain can be quickly controlled through standardized management, and thus improving the life quality of patients.
出处
《医院管理论坛》
2016年第1期45-47,共3页
Hospital Management Forum
关键词
癌痛
剂量滴定
护理
Cancer Pain
Dosage Titration
Nursing
