摘要
目的以WHO规定的癌痛三阶梯止痛治疗原则、美国NCCN癌痛治疗指南为依据,分析中国肿瘤患者使用镇痛药物的现状,为癌痛治疗药品的科学管理和合理应用提供参考。方法数据来自《医院处方分析合作项目》,2009-2012年全国9家肿瘤专科医院门诊处方使用镇痛药物数据,每家医院每年随机抽取40 d,门诊处方项目包括患者基本信息、用药情况、诊断和用药金额;用Foxpro 8.0数据库软件进行统计分析。结果使用镇痛药的患者占全部肿瘤患者人数的7%,镇痛药金额占全部肿瘤患者用药总金额的1.9%。无论从用药金额还是使用人数来看,患者镇痛均以口服、外用给药途径为主。用药人数排前20位的镇痛药中,羟考酮/对乙酰氨基酚占32%,位居首位,其次为吗啡片、芬太尼贴和羟考酮片,分别占10.3%、9.1%和7.9%,另外,哌替啶占0.9%。用药金额排前20位镇痛药中,羟考酮/对乙酰氨基酚最多,其次为芬太尼贴、羟考酮片和吗啡片。用药类型主要以阿片类为主,占镇痛药金额的60.2%,其次为阿片与非甾体抗炎药的复方制剂(占32%),非甾体类抗炎药占4.5%,非阿片类中枢镇痛药占2.8%,其他0.5%。患者使用的复方制剂中,对乙酰氨基酚用量超过NCCN指南所规定4 g/d的人数占使用镇痛药人数的0.1%。结论中国癌痛治疗基本遵从WHO推行的三阶梯用药原则,但是仍远未达到NCCN指南的目标,癌痛治疗有待进一步规范。
Objective To analyse the present situation of Chinese cancer patients using analgesic drugs according to the Three-step Analgesic Ladder Framework of the WHO and the guidelines of NCCN,then provide reference for scientific management and rational use of cancer analgesics.Methods The data was from Chinese 9 tumour special hospitals analgesic outpatient prescriptions in Hospital Prescription Analysis of Cooperative Project,40-day-prescriptions were randomly selected each year from 2009 to 2012,which included patients＇ basic information,the medications situation,diagnosis and medications amount in every tumor hospital.Then Foxpro 8.0 database software was used.Results Patients using analgesics accounted for 7 ％ of the total number of cancer patients and the analgesic amount accounted for 1.9％.Oral and external either from the analgesic amount or the number of patients using analgesic were the main way.Oxycodone ＆ acetaminophen ranked first of the top 20 analgesic （accounted for 32 ％ of the number of people using analgesic）,followed by morphine tablet,fentanyl patch and oxycodone tablet （accounted for 10.3 ％,9.1％ and 7.9 ％ respectively）.In addition,pethidine accounted for 0.9％.Oxycodone ＆ acetaminophen was in the first top 20 of analgesic amount too,followed by fentanyl patch,oxycodone tablet and morphine tablet.The main medication type was opioid （accounted for 60.2％ of the amount of pain relievers）,followed by compound preparation of opioid and NSAIDs（accounted for 32％）,NSAIDs（4.5％）,non opioid analgesic（2.8％） and others（0.5％）.About 0.1％ compound preparation analgesic users used acetamidophenol dosage of ＞ 4 g/d which ruled by NCCN guidelines.Conclusion Chinese cancer pain treatment mainly obey the Three-step Analgesic Ladder Framework of the WHO,but is still far from NCCN guidelines,it remains to be further standardized.
出处
《实用药物与临床》
CAS
2014年第9期1219-1223,共5页
Practical Pharmacy and Clinical Remedies
关键词
肿瘤
医院
癌痛
镇痛药
处方
Tumour
Hospital
Cancer pain
Analgesic
Prescription
