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題名:臺灣地區十年來阿片類止痛藥使用趨勢之探討
書刊名:中華公共衛生雜誌
作者:許俊卿李志恒
作者(外文):Hsu, Chun-chingLi, Jih-heng
出版日期:1998
卷期:17:6
頁次:頁495-503
主題關鍵詞:嗎啡可待因配西汀麻醉藥品使用量MorphineCodeinePethidineNarcotic consumption
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
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     調查臺灣地區1987年至1996年十年間阿片類止痛藥使用量成長情形,嗎啡口服劑成長17倍,注射劑成長9倍;可待因口服劑成長1.4倍,注射劑成長1.7倍;配西汀口服劑成長1.6倍,注射劑未見成長;吩坦尼注射劑成長2.7倍。嗎啡口服劑每年均為正成長,年成長率平均為38%,注射劑則除1989及1993兩年為負成長外,其餘為正成長,於1992年高達116%。可待因口服及注射劑年成長率為正負互見;配西汀口服及注射劑之年成長率都在±20%內,無大幅衰退或增加;吩坦尼注射劑年成長率則在5%∼17%之間。嗎啡為WHO推薦之癌症疼痛治療主要用藥,臺灣地區使用量快速成長,但如以 1991至1995年之每百萬人口每天嗎啡使用量為例,僅及英國的四十一分之一、美國的二十五分之一、日本的四分之一,顯示我國癌症疼痛治療仍有努力的空間。阻礙阿片類止痛藥使用的因素很多,仍需調查確切原因,同時應對醫事人員加強正確癌症疼痛醫療之教育,使癌症疼痛病人能獲得更妥善的醫療照顧。
     Selected narcotic drugs purchased by, manufactured by and managed by the National Narcotics Bureau between 1987 and 1996 in Taiwan were reviewed for the requirement trend. The requirement for morphine has increased 17 and 9 folds in oral (o) and injectable (i) preparations, respectively. The increases in other opioids were less substantial: 1.4 (o) and 1.7 (i) folds for codeine; 1.6 (o) folds and no (i) increase for pethidine; and 2.7 (i) folds for fentanyl. The use of oral morphine has constantly incre ased with an average annual growth ratio of 38% except that a slight lag was observed in 1989 and 1993. The use of morphine injections has steady increase with the highest growth of 116% in 1992. For oral and injectable forms of codeine and pethidine, the annual growth ratios have remained stagnant. The annual growths of fentanyl injections ranged between 5% and 17%. The growth of using morphine seemed very rapid, yet the average daily morphine consumption in Taiwan was still far behind that of many de veloped countries. Based on the "defined daily doses" per million people, the daily morphine requirement compared with that of other nations was much lower in Taiwan: one to 41 compared with the U.K., one to 25 compared with the U.S., or one to four compared with Japan. In summary, the amount of narcotics supplements in the past in Taiwan suggests that patients might have received inadequate palliative care for cancer pain and other medical events. Further investigation on factors that might impede the u se of opioid analgesics is expected. In addition, educational programs for medical professionals on proper pain controls are imperatively required.
期刊論文
1.Sun, W. Z.、Hou, W. Y.、Li, J. H.(1996)。Republic of China: status of cancer pain and palliative care。Journal of Pain and Symptom Management,12,127-129。  new window
2.Ward, S. E.、Goldberg, N.、Miller-McCauley, V.、Mueller, C.、Nolan, A.、Pawlik-Plank, D.、Robbins, A.、Stormoen, D.、Weissman, D. E.(1993)。Patient-related barriers to management of cancer pain。Pain,52(3),319-324。  new window
3.Daut, R. L.、Cleeland, C. S.(1982)。The prevalence and severity of pain in cancer。Cancer,50(9),1913-1918。  new window
4.Cleeland, C. S.、Cleeland, L. M.、Dar, R.、Rinehardt, L. C.(1986)。Factors influencing physician management of cancer pain。Cancer,58(3),796-800。  new window
5.Cleeland, C. S.(1984)。The impact of pain on the patient with cancer。Cancer,54(11),2635-2641。  new window
6.Cleeland, C. S.、Gonin, R.、Hatfield, A. K.(1994)。Pain and it's treatments in outpatients with metastatic cancer。The New England J of Medicine,330,592-596。  new window
7.Foley, K. M.(1987)。Pain syndromes in patients with cancer。Medical Clinics of North America,71,169-184。  new window
8.孫維仁、陳大梁、湯兆順、曾清楷、黃芳彥(19910900)。臺灣地區口服嗎啡類止痛藥使用量之探討。中華民國癌症醫學會雜誌,7(3),21-28。  延伸查詢new window
9.林仙養、孫維仁、侯文詠(19920600)。影響醫學中心嗎啡類藥品使用因素之探討。中華民國癌症醫學會雜誌,8(2),19-29。  延伸查詢new window
10.鄭澄寰、何善台、高尚志、葛魯蘋(1991)。癌症疼痛及相關因子的探討。麻醉學雜誌,29,653-657。  延伸查詢new window
11.吳守謙(1997)。引進麻醉藥品新製劑讓疼痛患者得到更周全的照護。衛生報導,71,18-20。  延伸查詢new window
12.孫維仁、Chen, T. L.、Fan, S. T.、Peng, W. L.、Wang, M. S.、Huang, F. Y.(19920500)。Can Cancer Pain Attenuate the Physical Dependence on Chronic Long-Term Morphine Treatment?。臺灣醫學會雜誌,91(5),513-520。  new window
13.Zhou, H. H.、Sheller, J. R.、Nu, H.、Wood, M.、Wood, A. J.(1993)。Ethnic differences in response to morphine。Clinical Pharmacology &Therapeutics,54,507-513。  new window
研究報告
1.行政院衛生署(1996)。衛生統計。臺北:行政院衛生署。  延伸查詢new window
圖書
1.World Health Organization(1990)。Cancer pain relief and palliative care: report of WHO expert committee。Geneva:WHO。  new window
2.World Health Organization(1986)。Cancer pain relief。Geneva:WHO。  new window
3.World Health Organization(1996)。Cancer pain relief: with a guide to opioid availability。Geneva:WHO。  new window
4.行政院衛生署麻醉藥品經理處(1994)。麻醉藥品使用管理手冊。台北:行政院衛生署麻醉藥品經理處。  延伸查詢new window
5.International Narcotics Control Board(1995)。Narcotic drugs-estimated world requirements for 1997, Statistics for 1995。Vienna:INCB。  new window
6.International Narcotics Control Board(1995)。Narcotic drugs-estimated world requirements for 1996, statistics for 1994。Vienna:INCB。  new window
7.International Narcotics Control Board(1994)。Narcotic drugs-estimated world requirements for 1995, statistics for 1993。Vienna:INCB。  new window
8.International Narcotics Control Board(1993)。Narcotic drugs-estimated world requirements for 1994, statistics for 1992。Vienna:INCB。  new window
9.International Narcotics Control Board(1992)。Narcotic drugs-estimated world requirements for 1993, statistics for 1991。Vienna:INCB。  new window
10.王志中、何善台、李志恒(1996)。癌症疼痛治療學。台北:財團法人大地之愛癌症基金會。  延伸查詢new window
11.United Nations(1996)。Report of the International Narcotics Control Board for 1995-availability of opiates for medical needs。New York:United Nations。  new window
 
 
 
 
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