片类药物的使用和随后的狂妄风险在晚期癌症患者在息治疗:一个多中心注册研究研究
Shin Hye Yoo1, Jiseung Kang2,3, Hyeon Jin Kim4,5
1Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, South Korea.
Scientific reports
|March 13, 2024
概括
在晚期癌症患者中,阿片类药物的使用显著增加了妄想风险,更高的剂量带来更大的危险. 这项研究强调了在息治疗中需要谨慎使用阿片类药物管理的必要性.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 神经精神病学是一种神经精神病学.
背景情况:
- 阿片类止痛药被广泛用于治疗晚期癌症的疼痛.
- 神经精神病学的副作用,如妄想症,在这个人群中是一个重大问题.
- 了解阿片类药物使用和妄想之间的联系对于优化患者护理至关重要.
研究的目的:
- 调查阿片类药物使用与晚期癌症患者妄风险之间的关联.
- 探索阿片类药物管理与狂妄发生之间的剂量依赖关系.
- 为了确定增加患有 Delirium 易感性的患者因素.
主要方法:
- 使用韩国 (2019-2020) 多中心患者登记表队列进行的回顾性观察性研究.
- 通过瘤专家的回顾性图表审查收集的数据.
- 分析包括不匹配的和 propensity-score 匹配的队列,并进行分层分析. 根据DSM-IV标准诊断出 Delirium 的情况.
主要成果:
- 服用阿片类药物与 Delirium 的发生增加有显著的关联 (OR, 2.02).
- 观察到一种剂量依赖的关系,高剂量阿片类药物使用者显示出明显更高的风险 (OR,5.75).
- 年龄较大,男性性别,缺乏化疗和非肥胖状态与 Delirium 风险增加有关.
结论:
- 阿片类药物的使用与晚期癌症患者中痴呆风险的剂量依赖性增加显著相关.
- 特定的患者特征可能会增加对阿片类药物诱导狂妄的易感性.
- 仔细考虑阿片类药物剂量至关重要,以平衡疼痛控制和尽量减少晚期癌症护理中的妄想风险.
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