强阿片药物对阿片耐受的晚期癌症患者肝功能的影响.pdfVIP

·550 · 实用药物与临床2014年第17 卷第5期　 Practical Pharmacy And Clinical Remedies,2014,Vol.17,No.5 强阿片药物对阿片耐受的晚期癌症患者肝功能的影响 王晓芳,王玉梅 　 　 [摘　 要]　 目的　 观察阿片耐受患者用药前后肝功能水平的变化,探讨长期应用强阿片类药物对患者肝功 能的影响。 方法　 搜集我院52例联合或单独使用吗啡、羟考酮、芬太尼超过30 d 的晚期癌症患者,进行疼痛治 疗情况分析,并比较用药前后血清肝功能水平。 结果　 晚期癌症患者在使用耐受剂量强阿片类药后 1周、2 周及 1个月肝功能无显著变化(P0．05),在患者病程终末期谷草转氨酶、直接胆红素、间接胆红素水平与用药初期相 比,差异有统计学意义(P0．05)。 结论　 规范合理使用强阿片类药物初期不会导致肝损伤,长期应用应监测患 者肝功能水平;对于癌症患者进行规范化癌痛治疗,可确保存在肝损伤风险的患者在使用强阿片类药物后,不会 显著增加肝损伤的风险。 [关键词]　 阿片类药物;晚期癌痛;肝功能 Effect of opioidsonliverfunctioninopioid-tolerancedpatients　 WANGXiao-fang,WANG Yu-mei (Department of Hospice Ward,Shengjing Hospital of China Medical University,Shenyang 110004,China) 　 　 [Abstract]　 Objective　 To observe the change of liver function before and after treatment in patientswith opi- oid tolerance and investigate the effects of long-term application of strong opioid drugs on liver function of patients. Methods　 52 cases of terminal cancer patients in our hospital who used morphine,oxycodone,fentanyljoint or alone for more than30 dayswere selectedandthetreatment ofpainandcompare serum level ofliver functionbeforeandaf- ter medication were analyzed.Results　 The liver function of terminal cancer patientswith tolerable dose strong opioid drugs for 1weeks,2weeksand1monthhadnosignificantchange (P0．05).Thelevelofaspartateaminotransferase, direct bilirubin,indirect bilirubin in patients with end-stage levels had significant difference compared with the initial treatment (P0．05).Conclusion　 Normative and rational use of strong opioids at the initial stage does not lead to liver damage,but long-term use of strong opioids should monitor the liver function of patients;Standardizedpain treat- ment for patientswith cancer can ensure that patientsatrisk of liver damageafter using strong opioidswill not signifi- cantly increase