Chinese General Practice ›› 2022, Vol. 25 ›› Issue (32): 4023-4028.DOI: 10.12114/j.issn.1007-9572.2022.0526
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Received:
2022-07-10
Revised:
2022-08-02
Published:
2022-11-15
Online:
2022-08-11
Contact:
GONG Liyan
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通讯作者:
龚黎燕
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0526
24 h口服吗啡剂量 | 剂量转换比(口服吗啡∶口服美沙酮) |
---|---|
<100 mg | 4∶1 |
100~ mg | 8∶1 |
300~ mg | 10∶1 |
600~ mg | 12∶1 |
800~ mg | 15∶1 |
≥1 000 mg | 20∶1 |
Table 1 Conversion ratio between oral methadone and oral morphine
24 h口服吗啡剂量 | 剂量转换比(口服吗啡∶口服美沙酮) |
---|---|
<100 mg | 4∶1 |
100~ mg | 8∶1 |
300~ mg | 10∶1 |
600~ mg | 12∶1 |
800~ mg | 15∶1 |
≥1 000 mg | 20∶1 |
疼痛性质 | 例数 |
---|---|
骨转移性癌痛 | 30 |
内脏痛 | 17 |
神经侵犯或神经压迫性痛 | 13 |
内脏痛+骨转移性癌痛 | 12 |
内脏痛+神经侵犯或神经压迫性痛 | 12 |
骨转移性癌痛+神经侵犯或神经压迫性痛 | 16 |
Table 2 Analysis of the nature of pain in 100 inpatients with refractory carcinous pain
疼痛性质 | 例数 |
---|---|
骨转移性癌痛 | 30 |
内脏痛 | 17 |
神经侵犯或神经压迫性痛 | 13 |
内脏痛+骨转移性癌痛 | 12 |
内脏痛+神经侵犯或神经压迫性痛 | 12 |
骨转移性癌痛+神经侵犯或神经压迫性痛 | 16 |
24 h口服吗啡剂量 | 例数 | 1周美沙酮剂量(mg) | 实际1周剂量转换率(口服吗啡∶口服美沙酮) | 2周美沙酮剂量(mg) | 实际2周剂量转换率(口服吗啡∶口服美沙酮) |
---|---|---|---|---|---|
<100 mg | 9 | 23.89±10.83 | (3.83±1.94)∶1 | 30.00±7.50 | (2.72±1.05)∶1 |
100~ mg | 28 | 35.18±13.09 | (5.74±1.86)∶1 | 53.04±26.29 | (4.18±2.38)∶1 |
300~ mg | 29 | 55.86±18.76 | (7.93±2.25)∶1 | 55.86±25.32 | (8.29±2.59)∶1 |
600~ mg | 8 | 69.38±26.52 | (10.88±3.55)∶1 | 69.38±42.38 | (11.66±4.65)∶1 |
800~ mg | 7 | 81.43±8.02 | (11.10±1.50)∶1 | 102.86±34.02 | (11.15±1.87)∶1 |
≥1 000 mg | 15 | 125.67±28.90 | (16.01±8.32)∶1 | 123.00±45.07 | (16.29±7.31)∶1 |
Table 3 Methadone conversion situation of 96 inpatients with refractory carcinous pain
24 h口服吗啡剂量 | 例数 | 1周美沙酮剂量(mg) | 实际1周剂量转换率(口服吗啡∶口服美沙酮) | 2周美沙酮剂量(mg) | 实际2周剂量转换率(口服吗啡∶口服美沙酮) |
---|---|---|---|---|---|
<100 mg | 9 | 23.89±10.83 | (3.83±1.94)∶1 | 30.00±7.50 | (2.72±1.05)∶1 |
100~ mg | 28 | 35.18±13.09 | (5.74±1.86)∶1 | 53.04±26.29 | (4.18±2.38)∶1 |
300~ mg | 29 | 55.86±18.76 | (7.93±2.25)∶1 | 55.86±25.32 | (8.29±2.59)∶1 |
600~ mg | 8 | 69.38±26.52 | (10.88±3.55)∶1 | 69.38±42.38 | (11.66±4.65)∶1 |
800~ mg | 7 | 81.43±8.02 | (11.10±1.50)∶1 | 102.86±34.02 | (11.15±1.87)∶1 |
≥1 000 mg | 15 | 125.67±28.90 | (16.01±8.32)∶1 | 123.00±45.07 | (16.29±7.31)∶1 |
疼痛指标 | 转换前 | 转换后1周 | 转换后2周 | F值 | P值 |
---|---|---|---|---|---|
平均NRS评分(分) | 6.82±1.36 | 2.96±1.27a | 2.78±1.13a | 317.0 | <0.001 |
爆发痛次数(次) | 5.60±1.34 | 1.55±1.27a | 1.35±1.12a | 354.0 | <0.001 |
Table 4 Changes of pain intensity and frequency of breakthrough pain in 96 inpatients with refractory carcinous pain
疼痛指标 | 转换前 | 转换后1周 | 转换后2周 | F值 | P值 |
---|---|---|---|---|---|
平均NRS评分(分) | 6.82±1.36 | 2.96±1.27a | 2.78±1.13a | 317.0 | <0.001 |
爆发痛次数(次) | 5.60±1.34 | 1.55±1.27a | 1.35±1.12a | 354.0 | <0.001 |
不良反应 | 转换前(n=96) | 转换后1周(n=96) | 转换后2周(n=96) | χ2值 | P值 |
---|---|---|---|---|---|
口干 | 25(26.0) | 22(22.9) | 22(22.9) | 0.343 | 0.842 |
恶心 | 24(25.0) | 10(10.4)a | 9(9.4)a | 11.536 | 0.003 |
呕吐 | 15(15.6) | 5(5.2)a | 2(2.1)a | 13.681 | 0.001 |
便秘 | 42(43.8) | 30(31.3) | 30(31.3) | 4.372 | 0.112 |
头晕 | 10(10.4) | 4(4.2) | 4(4.2) | 4.481 | 0.106 |
尿潴留 | 2(2.1) | 1(1.0) | 1(1.0) | 0.507 | 0.776 |
嗜睡 | 5(5.2) | 2(2.1) | 2(2.1) | 2.065 | 0.356 |
幻觉 | 6(6.3) | 5(5.2) | 4(4.2) | 0.422 | 0.810 |
冷汗 | 11(11.5) | 9(9.4) | 10(10.4) | 0.223 | 0.894 |
瘙痒 | 3(3.1) | 1(1.0) | 1(1.0) | 1.628 | 0.443 |
Table 5 Incidence of adverse reactions before and after the conversion of morphine to methadone
不良反应 | 转换前(n=96) | 转换后1周(n=96) | 转换后2周(n=96) | χ2值 | P值 |
---|---|---|---|---|---|
口干 | 25(26.0) | 22(22.9) | 22(22.9) | 0.343 | 0.842 |
恶心 | 24(25.0) | 10(10.4)a | 9(9.4)a | 11.536 | 0.003 |
呕吐 | 15(15.6) | 5(5.2)a | 2(2.1)a | 13.681 | 0.001 |
便秘 | 42(43.8) | 30(31.3) | 30(31.3) | 4.372 | 0.112 |
头晕 | 10(10.4) | 4(4.2) | 4(4.2) | 4.481 | 0.106 |
尿潴留 | 2(2.1) | 1(1.0) | 1(1.0) | 0.507 | 0.776 |
嗜睡 | 5(5.2) | 2(2.1) | 2(2.1) | 2.065 | 0.356 |
幻觉 | 6(6.3) | 5(5.2) | 4(4.2) | 0.422 | 0.810 |
冷汗 | 11(11.5) | 9(9.4) | 10(10.4) | 0.223 | 0.894 |
瘙痒 | 3(3.1) | 1(1.0) | 1(1.0) | 1.628 | 0.443 |
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