吩坦尼貼片之疼痛控制療效及生活品質評估

本研究主要在探討安寧病房癌末病人，使用吩坦尼貼片控制疼痛症狀之療效及對生活品質改善之評估，以中部地區某醫學中心自民國九十二年七月至民國九十二年十二月間在安寧病房住院之癌症病人爲收案對象，結案共36份，經統計後結果得知：使用吩坦尼貼片控制癌症病人疼痛症狀，病人的疼痛分數由第一週4.5±2.3分（中度疼痛），減少至第四週2.4±1.8分（輕度疼痛），30位(83%)病人完成四週的評估，6位(17%)病人因爲疾病進展於四週內死亡，沒有病人因爲吩坦尼貼片引起的嚴重副作用退出研究。使用SF-36評估生活品質，只有身體疼痛部分獲得改善。研究者評值對31位(83.8%)病人的疼痛控制效果感到滿意，研究結果顯示吩坦尼貼片控制癌症病人的疼痛效果顯著，提昇疼痛控制的照顧品質，但不能提升癌症病人的生活品質。

關鍵字

吩坦尼貼片；疼痛控制；癌症；生活品質；安寧療護

並列摘要

Introduction: Fentanyl TTS is a strong, convenient opioid for moderate to severe pain relief. The main effect is to relief pain. However, it remains controversial whether it could improve quality of life in terminal cancer or just relief pain. Our aim is to evaluate whether Fentanyl TTS could improve quality of life in terminal cancer patient. Method: The inclusion criteria were patient who were older than 18 years cancer terminal patient; experiencing moderate or severe pain which strong opioid is necessary; not using Fentanyl TTS in recent one month; in need of Fentanyl TTS for pain control after doctor's evaluation. There were 36 patients recruited from July, 2003 to Dec, 2003 in a hospice palliative ward in Mid-Taiwan. SF-36 was used for the evaluation of quality of life. We used 0-10 numeric pain intensity scales to assess pain intensity. Basic personal data was collected. We recorded data at 1st, 3rd, and 4th week after Fentanyl TTS. Results: Thirty six patients were enrolled, but 6 patients died during the study period due to cancer progression. In total, the mean of age was 59.6. Twenty three patients (63.9%) were male and 13 patients (36.1%) were female. Thirty one patients (86.1%) were satisfied with their pain relief. Application intervals had to be shortened in one patient (from 3 days to 2 days). 100% of those who had completed the study were willing to continue the use of Fantanyl TTS. The pain intensity scale had been improved from 4.5±2.3 (1st week) to 2.4±1.8 (4th) week) (p＜0.01). The dose of Fentanyl TTS increased over time which was from 49.3±30.9 μg/h(1(superscript st) week) to 55.4±32.9 μg/h(4(superscript th) week) (p＜0.001). More than half of patients needed other opioid drugs for breakthrough pain. No obvious adverse effect was found during study period. The quality of life evaluation using SF-36 improved only in body pain domain which was from 31.0±19.0 to 47.5±19.4 (p＜0.01). Conclusions: Fentanyl TTS can effectively relieve pain but cannot improve quality of life in terminal cancer patient. We though that SF-36 may be not a suitable tool to evaluate the quality of life in terminal cancer patient

並列關鍵字

Fentanyl TTS ； pain control ； quality of life ； cancer ； palliative care

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吩坦尼貼片之疼痛控制療效及生活品質評估

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