Tajitsu Takeya, Matsuura Shinobu, Kawagoe Koh
Clinic Kawagoe.
Gan To Kagaku Ryoho. 2009 Dec;36 Suppl 1:81-3.
From July 1 in 2003 through December 31 in 2008, 150 terminal lung cancer patients were provided home hospice care by us and died at home, whereas the following clinical characteristics along with the practical care we provided were examined by comparing with 432 non-lung cancer patients who died at home during that period. The frequency of home death (lung cancer/control group, 96.8/96.2%) and the duration of caring at home (48.7/54.6 days) did not show a significant difference. Significant differences were observed in suffering of breathing (62.7/31.5%), use of the opioids (96.0/ 87.5%), slow releasing oral morphine (32.7/18.1%), morphine suppository (73.3/56.5%), morphine injected subcutaneously (37.3/25.7%), slow releasing oral oxycodone (61.3/37.3%), and fentanyl (20.0/46.1%). These findings led us to conclude: (1) the main symptom, in case of the terminal lung cancer patients, was to control a difficulty in breathing, (2) the appropriate opioids were morphine and oxycodone in palliation of respiratory difficulties, (3) fentanyl was inappropriate for palliation of respiratory difficulties.
2003年7月1日至2008年12月31日期间,我们为150例晚期肺癌患者提供了居家临终关怀服务,这些患者均在家中死亡。同时,我们将这些患者的临床特征及实际提供的护理与同期在家中死亡的432例非肺癌患者进行比较。在家中死亡的频率(肺癌组/对照组,96.8%/96.2%)和居家护理时长(48.7天/54.6天)差异无统计学意义。在呼吸困难(62.7%/31.5%)、阿片类药物使用(96.0%/87.5%)、缓释口服吗啡(32.7%/18.1%)、吗啡栓剂(73.3%/56.5%)、皮下注射吗啡(37.3%/25.7%)、缓释口服羟考酮(61.3%/37.3%)以及芬太尼(20.0%/46.1%)方面观察到显著差异。这些结果使我们得出以下结论:(1)晚期肺癌患者的主要症状是控制呼吸困难;(2)缓解呼吸困难的合适阿片类药物是吗啡和羟考酮;(3)芬太尼不适用于缓解呼吸困难。