1、 癌症疼痛姑息治疗癌症疼痛姑息治疗 Cancer Pain RelieveCancer Pain Relieve 北京协和医院呼吸科北京协和医院呼吸科 张力张力 李龙芸李龙芸我国2019年AustriaAustriaUSAUSAFranceFranceUKUKGermanyGermanyJapanJapanTaiwaiTaiwaiChinaChina74.9574.95Kg/百万人口百万人口0 0500050001000010000150001500020000200002500025000300003000035000350004000040000IrelandIrelandDenmarkD
2、enmarkUKUKSwitzerlandSwitzerlandGermanyGermanyIndiaIndiaItalyItalyChinaChinaTotalTotalMorphiMorphinene：骨受累阿阿片片类类药药物物及及其其等等效效剂剂量量药物口 服 剂 量 静脉和肌肉注射剂量 持续时间（小时）吗啡30103-4氢吗啡酮5-7515-23-4芬太尼25ug（经皮）48-72度冷丁300752-4美砂酮2010-156氢可酮30NA3-4羟考酮30NA3-4可待因2001203-4NA=无静脉和肌肉注射剂型药物药物强度强度作用时间作用时间(h(h）MorphineMorphine
3、Morphine SRMorphine SRMorphine SR+Morphine SR+Fentanyl TTSFentanyl TTSOxycodoneOxycodoneHydromorphoneHydromorphoneMethadoneMethadone1 11 11 170702+2+7.57.53-43-44 48-128-1218-2418-2448-7248-728-128-128-128-126-8+6-8+PethidinePethidinePentazocinePentazocine1/81/81/81/82-32-32-32-3D Do os sa ag ge e(O
4、 Or ra al l/m mg g)I In nt te er rv va al l(h hr rs s.)S Si id de e e ef ff fe ec ct ts s A An na al lg ge et ti ic cE Eq qu ui iv va al le en nc ce et to o m mo or rp ph hi in ne eT Ti il li id di in n5 50 0-1 15 50 08 8-1 12 2D Di iz zz zi in ne es ss sN Na au us se ea a1 1/1 10 0T Tr ra am ma ad
5、do ol l5 50 0-2 20 00 08 8-1 12 2N Na au us se ea aV Vo om mi it ti in ng g1 1/1 15 5D Di ih hy yd dr ro oc co od de ei in n3 30 0-1 12 20 08 8-1 12 2C Co on ns st ti ip pa at ti io on nN Na au us se ea a1 1/6 6D De ex xt tr ro op pr ro op po ox xy yp ph he en n1 15 50 08 8-1 12 2D Di iz zz zi in ne es ss sN Na au us se ea a1 1/1 10 0
