即释吗啡治疗晚期癌症呼吸困难
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摘要
晚期癌症患者呼吸困难往往是多因素的,包括癌症本身引起的,全身状态导致的,其他并发症和治疗过程中的不良反应。目前,国内无统一的临床治疗规范,多采用姑息治疗方法,阿片类药物吗啡为国际推荐的首选缓解药物,本文总结国内外相关报道,对即释吗啡治疗晚期癌症患者呼吸困难的机制、给药途径及不良反应方面进行综述,指导临床用药。
The dyspnea in patients with advanced cancer is often caused by multi factors,including cancer itself,the whole body state,the other complications and the side effects during treatment. At present,there is no unitive domestic clinical treatment standard,it is often treated by palliative therapy,and opioids morphine is the prefered drug recommended by international organization. This article summarizes the domestic and foreign relevant reports about the mechanism of immediate release morphine treatment of advanced cancer dyspnea, administration route and side effects for guiding the clinical medication.
The dyspnea in patients with advanced cancer is often caused by multi factors,including cancer itself,the whole body state,the other complications and the side effects during treatment. At present,there is no unitive domestic clinical treatment standard,it is often treated by palliative therapy,and opioids morphine is the prefered drug recommended by international organization. This article summarizes the domestic and foreign relevant reports about the mechanism of immediate release morphine treatment of advanced cancer dyspnea, administration route and side effects for guiding the clinical medication.
引文
1 Ben-Aharon I,Gafter-Gvili A,Leibovici L,et al. Interventions for alleviating cancer-related dysp-nea:A systematic review and meta-analysis. Acta Oncol,2012,51:996-1008.
2 张杰,武春娟,王飞,等.晚期肿瘤压疮患者采用水胶体敷料治疗临床价值分析.河北医药,2017,39:3827-3829.
3 张露露,姜斌.吗啡应用于终末期肿瘤患者呼吸困难的安全性研究.现代肿瘤医学2016,24:2452-2454.
4 Dy SM,Lorenz KA,Naeim A,et al. Evidence-based recommendations for cancer fatigue,ano-rexia,depression,and dyspnea. J Clin Oncol,2008,26:3886-3895.
5 于世英主编.临床肿瘤学.第1版.北京:科学出版社,2006. 501-503.
6 Bredin M,Corner J,Krishnasamy M,et al. Multicentre randomised controlled trial of nursing inter-vention for breathlessness in patients with lung cancer. BMJ,1999,318:901-904.
7 Bonnichon A,Le Floch H,Rivière F,et al. Dyspnea in lung cancer. Rev Pneumol Clin,2008,64:62-68.
8 Gamborg H,Riis J,Christrup L,et al. Effect of intraoral and subcutaneous morphine on dysp-nea at rest in terminal patients with primary lung cancer or lung metastases. J Opioid Manag,2013,9:269-274.
9 Pinna MA. A randomized crossover clinical trial to evaluate the efficacy of oral transmucosal fentanyl citrate in the treatment of dyspnea on exertion in patients with advanced cancer. Am J Hosp Palliat Care,2015,32:298-304.
10 Miura T,Matsumoto Y,Motonaga S,et al. Dyspnea,relative youth and low daily doses of opioids predict increased opioid dosage in the last week of a terminal cancer patient’s life. Jpn J Clin Oncol,2014,44:1082-1087.
11 Cheung WY,Zimmermann C. Pharmacologic management of cancerrelated pain,dyspnea,and nausea. Semin Oncol,2011,38:450-459.
12 Vargas-Bermúdez A,Cardenal F,Porta-Sales J,et al. Opioids for the management of dyspnea in cancer patients:Evidence of the last 15 yearsa systematic review. J Pain Palliat Care Phar-macother,2015,2:1-12.
13 Reuben DB,Mor V,Hiris J,et al. Clinical symptoms and length of survival patients of teminal cancer. Aichives of internal medicine. Arch Intern Med,1988,148:1586-1591.
14 Henoch I,Bergman B,Danielson E. Dyspnea experience and management strategies in patients with lung cancer. Psychooncology,2008,17:709-715.
15 蒋建军,李金祥,Mellar P. Davis.晚期癌症患者呼吸困难.中国医刊,2005,40:30-31.
16 刘珊,吴晓明.恶性肿瘤患者呼吸困难的诊治进展.中国疼痛医学杂志,2012,18:582-585.
17 Reddy SK,Parsons HA,Elsayem A,et al. Cha racteristics and correlates of dyspnea in patients with advanced cancer. J Palliat Med,2009,12:29-36.
18 Kauser F,Le Grand BS. Theophylline for unexplained dyspnea in palliat ive medicine:a case report. J Palliat Med,2008,11:510-513.
19 Navigante AH,Castro MA,Cerchietti LC. Morphine versus midazolam as upfro nt therapy to control dyspnea perception in cancer patients while its underlying cause is sought or treated. J Pain Symptom Manage,2010,39:820-830.
20 Viola R,Kiteley C,Lloyd NS,et al. The management of dyspnea in cancer patients:a systematic review. Support Care Cancer,2008,16:329-337.
21 Kallet RH. The role of inhaled opioids and furosemid e for the treatment of dyspnea. Respir Care,2007,52:900-910.
22 李洪英,张光华.癌症晚期呼吸困难的原因分析及护理对策,2005,11:1313-1314.
23 Willms H. Pleural punctures brought no improvement. Lung cancer patient with persistent dyspnea. MMW Fortschr Med,2009,151:16.
24 Ray-Coquard I,Morère JF,ScottéF,et al. Management of anemia in advanced breast and lung cancer patients in daily practice:results of a French survey. Adv Ther,2012,29:124-133.
25 刘峰,王美玲,袁海花,等.吗啡、甲强龙及氨茶碱治疗晚期肿瘤患者呼吸困难疗效比较.上海交通大学学报(医学版),2013,33:823-826.
26 Jennings AL,Davies AN,Higgins JP,et al. A systematic review of the use of opioids in the management of dyspnoea. Thorax,2002,57:939-944.
27 Cong Tian,Jiong-Yi Wang,Mei-Ling Wang,et al. Morphine versus methylprednisolone or aminophylline for relieving dyspnea in patients with advanced cancer in China:a retrospective study. Springerplus,2016,5:1945.
28 王雅敏.阿片类药物在治疗晚期COPD呼吸困难中的应用.四川医学,2004,25:1365-1367.
29 郑熙琳,严芳,高冬梅,等.吗啡治疗晚期癌症呼吸困难的临床观察及对策.现代预防医学,2011,38:1730-1731.
30 陈默思,刘兵.吗啡治疗晚期癌症患者呼吸困难.实用医学杂志,2009,25:2979.
31 Grimbert D,Lubin O,de Monte M,et al. Dyspnea and morphine aerosols in the palliative care of lung cancer. Rev Mal Respir,2004,21:1091-1097.
32 冯丽娟,陈凤菊,张冬林.皮下注射吗啡治疗晚期癌症呼吸困难60例.医药导报,2010,29:1297-1299.
33 谢峰,陈昌南,潘岐作,等.小剂量分次静脉注射吗啡治疗晚期肿瘤患者呼吸困难研究.临床医药文献杂志,2015,2:6794.
34 Estfan B,Mahmoud F,Shaheen P,et al. Respiratory function during parenteral opioid titration for cancer pain. Palliat Med,2007,21:81-86.
2 张杰,武春娟,王飞,等.晚期肿瘤压疮患者采用水胶体敷料治疗临床价值分析.河北医药,2017,39:3827-3829.
3 张露露,姜斌.吗啡应用于终末期肿瘤患者呼吸困难的安全性研究.现代肿瘤医学2016,24:2452-2454.
4 Dy SM,Lorenz KA,Naeim A,et al. Evidence-based recommendations for cancer fatigue,ano-rexia,depression,and dyspnea. J Clin Oncol,2008,26:3886-3895.
5 于世英主编.临床肿瘤学.第1版.北京:科学出版社,2006. 501-503.
6 Bredin M,Corner J,Krishnasamy M,et al. Multicentre randomised controlled trial of nursing inter-vention for breathlessness in patients with lung cancer. BMJ,1999,318:901-904.
7 Bonnichon A,Le Floch H,Rivière F,et al. Dyspnea in lung cancer. Rev Pneumol Clin,2008,64:62-68.
8 Gamborg H,Riis J,Christrup L,et al. Effect of intraoral and subcutaneous morphine on dysp-nea at rest in terminal patients with primary lung cancer or lung metastases. J Opioid Manag,2013,9:269-274.
9 Pinna MA. A randomized crossover clinical trial to evaluate the efficacy of oral transmucosal fentanyl citrate in the treatment of dyspnea on exertion in patients with advanced cancer. Am J Hosp Palliat Care,2015,32:298-304.
10 Miura T,Matsumoto Y,Motonaga S,et al. Dyspnea,relative youth and low daily doses of opioids predict increased opioid dosage in the last week of a terminal cancer patient’s life. Jpn J Clin Oncol,2014,44:1082-1087.
11 Cheung WY,Zimmermann C. Pharmacologic management of cancerrelated pain,dyspnea,and nausea. Semin Oncol,2011,38:450-459.
12 Vargas-Bermúdez A,Cardenal F,Porta-Sales J,et al. Opioids for the management of dyspnea in cancer patients:Evidence of the last 15 yearsa systematic review. J Pain Palliat Care Phar-macother,2015,2:1-12.
13 Reuben DB,Mor V,Hiris J,et al. Clinical symptoms and length of survival patients of teminal cancer. Aichives of internal medicine. Arch Intern Med,1988,148:1586-1591.
14 Henoch I,Bergman B,Danielson E. Dyspnea experience and management strategies in patients with lung cancer. Psychooncology,2008,17:709-715.
15 蒋建军,李金祥,Mellar P. Davis.晚期癌症患者呼吸困难.中国医刊,2005,40:30-31.
16 刘珊,吴晓明.恶性肿瘤患者呼吸困难的诊治进展.中国疼痛医学杂志,2012,18:582-585.
17 Reddy SK,Parsons HA,Elsayem A,et al. Cha racteristics and correlates of dyspnea in patients with advanced cancer. J Palliat Med,2009,12:29-36.
18 Kauser F,Le Grand BS. Theophylline for unexplained dyspnea in palliat ive medicine:a case report. J Palliat Med,2008,11:510-513.
19 Navigante AH,Castro MA,Cerchietti LC. Morphine versus midazolam as upfro nt therapy to control dyspnea perception in cancer patients while its underlying cause is sought or treated. J Pain Symptom Manage,2010,39:820-830.
20 Viola R,Kiteley C,Lloyd NS,et al. The management of dyspnea in cancer patients:a systematic review. Support Care Cancer,2008,16:329-337.
21 Kallet RH. The role of inhaled opioids and furosemid e for the treatment of dyspnea. Respir Care,2007,52:900-910.
22 李洪英,张光华.癌症晚期呼吸困难的原因分析及护理对策,2005,11:1313-1314.
23 Willms H. Pleural punctures brought no improvement. Lung cancer patient with persistent dyspnea. MMW Fortschr Med,2009,151:16.
24 Ray-Coquard I,Morère JF,ScottéF,et al. Management of anemia in advanced breast and lung cancer patients in daily practice:results of a French survey. Adv Ther,2012,29:124-133.
25 刘峰,王美玲,袁海花,等.吗啡、甲强龙及氨茶碱治疗晚期肿瘤患者呼吸困难疗效比较.上海交通大学学报(医学版),2013,33:823-826.
26 Jennings AL,Davies AN,Higgins JP,et al. A systematic review of the use of opioids in the management of dyspnoea. Thorax,2002,57:939-944.
27 Cong Tian,Jiong-Yi Wang,Mei-Ling Wang,et al. Morphine versus methylprednisolone or aminophylline for relieving dyspnea in patients with advanced cancer in China:a retrospective study. Springerplus,2016,5:1945.
28 王雅敏.阿片类药物在治疗晚期COPD呼吸困难中的应用.四川医学,2004,25:1365-1367.
29 郑熙琳,严芳,高冬梅,等.吗啡治疗晚期癌症呼吸困难的临床观察及对策.现代预防医学,2011,38:1730-1731.
30 陈默思,刘兵.吗啡治疗晚期癌症患者呼吸困难.实用医学杂志,2009,25:2979.
31 Grimbert D,Lubin O,de Monte M,et al. Dyspnea and morphine aerosols in the palliative care of lung cancer. Rev Mal Respir,2004,21:1091-1097.
32 冯丽娟,陈凤菊,张冬林.皮下注射吗啡治疗晚期癌症呼吸困难60例.医药导报,2010,29:1297-1299.
33 谢峰,陈昌南,潘岐作,等.小剂量分次静脉注射吗啡治疗晚期肿瘤患者呼吸困难研究.临床医药文献杂志,2015,2:6794.
34 Estfan B,Mahmoud F,Shaheen P,et al. Respiratory function during parenteral opioid titration for cancer pain. Palliat Med,2007,21:81-86.
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