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      肺癌患者阿片类药物应用现状与合理性分析:单中心回顾性研究 Translated title: Status and Rationality of Opioid Use in Lung Cancer Patients: A Single Center Retrospective Study

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          Abstract

          背景与目的

          癌痛严重影响患者体力活动、心理状态以及生活质量,甚至缩短患者生存时间,合理规范应用阿片类药物可有效控制癌痛。肺癌患者癌痛发病率高,需分析肺癌患者阿片类药物应用现状,以评估肺癌患者阿片类药物应用的合理性。

          方法

          回顾性分析2018年6月-2019年6月北京协和医院呼吸与危重症医学科肺癌住院患者的临床资料,分析305例应用阿片类药物的肺癌癌痛患者的临床信息和用药信息。

          结果

          应用阿片类药物的肺癌患者影响因素分析中,年龄与阿片药物应用种类为主要影响因素。男性比例高于女性,且男性患者应用阿片药物种类多、年龄多集中在60岁-69岁之间。我院肺癌患者应用阿片类药物品种和结构符合要求,用药频率最高的为羟考酮缓释片,限定日费用(defined daily cost, DDC)排名第一位同时序号比为1,同步性好。吗啡片和吗啡注射液用量低,肺癌患者整体爆发痛(breakthrough cancer pain, BTcP)控制良好。阿片类药物整体应用合理(93.4%),不合理项目主要为爆发痛处置和用药频率不合理以及超剂量问题。

          结论

          应用阿片类药物的肺癌癌痛患者多为男性,老年男性癌痛更难于控制,需要加强关注。我院肺癌患者阿片类药物整体应用合理,但仍需关注BTcP处置、阿片类药物用药剂量和特殊人群用药等问题。

          Translated abstract

          Background and objective

          Cancer pain affect the physical activity, psychological state and quality of life seriously, and even shortened the survival time of patients. Rational and standard application of opioids could control cancer pain effectively. Since the high incidence of cancer pain in lung cancer patients, the status of opioids application should be analyzed to evaluate the rationality of analgesic application in lung cancer patients.

          Methods

          The clinical data of 305 patients with lung cancer who were hospitalized in Department of Respiratory and Critical Care Medicine of Peking Union Medical College Hospital from June 2018 to June 2019 were analyzed retrospectively.

          Results

          In the analysis of factors affecting the use of opioids in lung cancer patients, age and drug kinds were the main influencing factors. The proportion of male patients was higher than female. Moreover, male patients used more kinds of opioids and were mostly between 60 and 69 years old. The variety and structure of opioids used in lung cancer patients in our hospital met the requirements. Oxycodone hydrochloride prolonged-release tablet has the highest frequency of application, and defined daily cost (DDC) ranked the first with a serial number ratio of 1, which showed good synchronization. The quantity of morphine tablet and morphine injection were low, and the overall breakthrough cancer pain (BTcP) in lung cancer patients was well controlled. The overall application of opioids were reasonable (93.4%), and the unreasonable items mainly included the disposal of BTcP and the unreasonable frequency of opioids, as well as overdose.

          Conclusion

          The majority of patients with lung cancer who take opioids are male, and the cancer pain in elderly men are more difficult to control, which needs to pay more attention. The overall application of opioids in the patients with lung cancer pain in our hospital are reasonable, but there are still some problems to focus, such as the disposal of BTcP, the dosage of opioids and the medication of special groups.

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          Most cited references 9

          • Record: found
          • Abstract: found
          • Article: not found

          The management of cancer-related breakthrough pain: recommendations of a task group of the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland.

          A task group of the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland (APM) was convened to produce some up-to-date, evidence-based, practical, clinical guidelines on the management of cancer-related breakthrough pain in adults. On the basis of a review of the literature, the task group was unable to make recommendations about any individual interventions, but was able to make a series of 12 recommendations about certain generic strategies. However, most of the aforementioned recommendations are based on limited evidence (i.e., case series, expert opinion). The task group also proposed a definition of breakthrough pain, and some diagnostic criteria for breakthrough pain.
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            • Record: found
            • Abstract: found
            • Article: not found

            Breakthrough cancer pain: an observational study of 1000 European oncology patients.

            Breakthrough pain is common in patients with cancer and is a significant cause of morbidity in this group of patients.
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              Cancer survivorship and opioid prescribing rates: A population-based matched cohort study among individuals with and without a history of cancer

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                Author and article information

                Contributors
                Journal
                Zhongguo Fei Ai Za Zhi
                Zhongguo Fei Ai Za Zhi
                ZGFAZZ
                Chinese Journal of Lung Cancer
                中国肺癌杂志编辑部 (天津市和平区南京路228号300020 )
                1009-3419
                1999-6187
                20 April 2020
                : 23
                : 4
                : 233-238
                Affiliations
                [1 ] 100730 北京,北京协和医院药剂科 Department of Pharmacy, Peking Union Medical College Hospital, Beijing 100730, China
                [2 ] 100730 北京,呼吸与危重症医学科 Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Beijing 100730, China
                Author notes
                张波, Bo ZHANG, E-mail: zhangbopumch@ 123456163.com
                Article
                zgfazz-23-4-233
                10.3779/j.issn.1009-3419.2020.102.12
                7210091
                32213265
                版权所有©《中国肺癌杂志》编辑部2020Copyright ©2020 Chinese Journal of Lung Cancer. All rights reserved.

                This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) License. See: https://creativecommons.org/licenses/by/3.0/.

                Funding
                Funded by: 北京市自然科学基金项目
                Award ID: 7194311
                Funded by: 国家自然科学基金项目
                Award ID: 81974183
                Funded by: the grants from National Natural Science Foundation of Beijing
                Award ID: 7194311
                Funded by: National Natural Science Foundation of China
                Award ID: 81974183
                本研究受北京市自然科学基金项目(No.7194311)和国家自然科学基金项目(No.81974183)资助
                This study was supported by the grants from National Natural Science Foundation of Beijing (to Yan XU)(No.7194311) and National Natural Science Foundation of China (to Wei ZUO)(No.81974183)
                Categories
                临床研究
                Cilinical Research

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