阿片类药物治疗儿童癌痛的研究进展

Research Progress of Opioids Therapy for Children with Cancer Pain

关键词:  阿片类药物  癌痛  儿童  不良反应  进展

Key words:  opioids  cancer pain  children  adverse reactions  progress

摘要:

目的 探讨癌痛儿童使用阿片类药物的临床研究现状和应用进展。方法 结合近几年国内外相关文献，从儿童的癌痛评估、阿片类药物用药方案、不良反应、当前临床使用现状等方面进行综述。结果 当前疼痛的评估工具众多，但在儿童癌痛中得到明确验证的较少。同时儿童这个特殊群体使用阿片类药物治疗癌痛的有效性和安全性的证据数量较少，临床使用受到了较大的限制。结论 在临床治疗过程中应根据患儿疾病特征、年龄、认知能力等选择适合评估其癌痛的最佳工具；根据患儿年龄、体质量、适应证、合并疾病、不良反应耐受性、适合儿童的给药方式等方面个体化选择阿片类药物，必要时采取多模式镇痛，以在缓解疼痛和药物不良反应之间取得平衡。未来对儿童群体治疗癌痛方面需引起更多的关注和研究。

Abstract:

OBJECTIVE To explore the clinical research status and application progress of opioids in children with cancer pain. METHODS Combined with relevant domestic and foreign literatures in recent years, this paper comprehensively discussed the evaluation of cancer pain in children, opioid medication regimens, adverse reaction and current clinical application status. RESULTS Many pain assessment tools were currently available, but it was found that only a few assessment tools had been specifically developed to examine cancer pain in children. Additionally, minimal evidence was found on the efficacy and safety of opioids for treating cancer pain in the special group of children children and its clinical use was greatly restricted. CONCLUSION During clinical treatment, the best cancer pain assessment tools should be selected according to the characteristics of the disease, age and cognitive ability of children. Treatment plans of opioids should be selected according to their age, weight, indications, concomitant disease, adverse reaction tolerance, suitable administration methods for children, and multimodal analgesia is adopted when necessary to achieve a balance between pain relief and adverse drug reactions. In the future, more research attention should be paid to the treatment of cancer pain in children.