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중등도 이상의 암성통증을 호소하는 노인 환자에 대한 고용량의 마약성 진통제의 이용: 전향적 관찰 연구
김정은(Jung Eun Kim),최윤선(Youn Seon Choi),이경희(Kyung Hee Lee),김준석(Jun Suk Kim),고수진(Su Jin Koh),백선경(Sun Kyung Baek),김시영(Si Young Kim),송홍숙(Hong Suk Song),임보라미(Bo Rami Lim) 대한임상노인의학회 2016 대한임상노인의학회지 Vol.17 No.1
Background: Despite the large number of elderly individuals who are dying of cancer in Korea, the quality of pain management remains poor. Thus, in this study, the safety and efficacy of using high-dose opioids to treat has been evaluated pain in elderly patients with cancer. Methods: Data from cancer patients (N=94) aged ≥65 years who were administered high-doses of opioids (≥120 mg/day) were collected at 38 hospitals between February 2009 and March 2010. After 8 weeks, changes in pain severity were examined using a numeric rating scale; in addition, the opioid dosages, quality of life parameters, and opioid-based adverse events were investigated. Results: Ninety-two patients were prescribed opioids at the beginning of the study and followed for 8 weeks. The mean pain intensity changed from 5.61±1.56 at baseline to 4.02±2.17 (P<0.001) after 8 weeks. The mean opioid dosage, expressed as oral morphine equivalents, changed from 178.86±76.88 at baseline to 288.54±389.09 (P=0.0025) after 8 weeks. The quality of life parameters, including daily activities, ambulation, and sleep, improved significantly after 8 weeks (P<0.001). At baseline, 44 patients (47.8%) complained of adverse effects such as constipation, dizziness, and nausea; the frequency of adverse events did not increase after 8 weeks. Conclusion: The use of high-dose opioids for treating cancer pain is safe, effective, and tolerable in elderly patients.