CAJ | 학술논문

目的：比较口服羟考酮控释片（oxycodone hydrochloride controlled-release tablets，OHCT）与静脉自控镇痛（patient-con?trolled intravenous analgesia，PCIA）治疗顽固性癌痛的疗效、不良反应、治疗费用以及患者的满意率。方法：收集2012年9月至2014年3月福建医科大学附属第二医院及南京军区福州总医院肿瘤内科收治的顽固性癌痛患者89例，其中OHCT组47例，治疗方案为口服羟考酮控释片60～400 mg/d，每12 h给药1次；PCIA组42例，给药方式为“背景量+患者自控给药量”模式，视患者镇痛效果调节药物浓度。比较两组镇痛效果、不良反应、治疗费用以及患者的满意率。结果：换算后两组镇痛模式吗啡日均剂量比较无显著性差异（P>0.05），PCIA组镇痛后24 h VAS评分及日均VAS评分低于OHCT组（P<0.05），PCIA组出现恶心、呕吐的频率低于OHCT组（P<0.05），PCIA组的治疗费用、满意率与OHCT组比较无显著性差异（P>0.05）。结论：PCIA组镇痛效果优于OHCT组，不良反应更小，而其治疗费用、满意率与OHCT组相仿，值得临床进一步推广。
목적：비교구복간고동공석편（oxycodone hydrochloride controlled-release tablets，OHCT）여정맥자공진통（patient-con?trolled intravenous analgesia，PCIA）치료완고성암통적료효、불량반응、치료비용이급환자적만의솔。방법：수집2012년9월지2014년3월복건의과대학부속제이의원급남경군구복주총의원종류내과수치적완고성암통환자89례，기중OHCT조47례，치료방안위구복간고동공석편60～400 mg/d，매12 h급약1차；PCIA조42례，급약방식위“배경량+환자자공급약량”모식，시환자진통효과조절약물농도。비교량조진통효과、불량반응、치료비용이급환자적만의솔。결과：환산후량조진통모식마배일균제량비교무현저성차이（P>0.05），PCIA조진통후24 h VAS평분급일균VAS평분저우OHCT조（P<0.05），PCIA조출현악심、구토적빈솔저우OHCT조（P<0.05），PCIA조적치료비용、만의솔여OHCT조비교무현저성차이（P>0.05）。결론：PCIA조진통효과우우OHCT조，불량반응경소，이기치료비용、만의솔여OHCT조상방，치득림상진일보추엄。
Objective:To compare the clinical efficacy of oxycodone hydrochloride controlled-release tablets (OHCT) and pa-tient-controlled intravenous analgesia (PCIA) in the treatment of intractable cancer pain. Methods:Retrospective analysis was conduct-ed to evaluate the intractable cancer pain of 89 elderly patients who were admitted to the medical oncology departments of The Second Affiliated Hospital of Fujian Medical University and the Fuzhou General Hospital of Nanjing Military Command between September 2012 and March 2014. Among the 89 patients, 47 were treated with OHCT, and 42 received PCIA. The total dosage ranged from 60 mg/d to 400 mg/d PO q12h for patients in the OHCT group, whereas a"background dose+patient-controlled dose"mode was adopted for patients in the PCIA group. The therapeutic efficacy, presence of adverse reactions, cost of treatment, and degree of patient satisfaction were compared between the two groups. Results:The average dosages of analgesics in the two groups were almost the same (P>0.05). Visual analogue scale (VAS) values and daily average VAS values were both lower in the PCIA group than in the OHCT group at 24 h after analgesia (P<0.05). The incidence of adverse reactions, such as nausea and vomiting, was also lower in the PCIA group than in the OHCT group (P<0.05). The cost of treatment and degree of patient satisfaction were the same in both groups (P>0.05). Conclusion:Pa-tients who received PCIA attained better analgesia and exhibited less adverse reactions than those who received OHCT whereas the treatment cost and patient satisfaction did not differ in both groups.