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目的：探讨多瑞吉在带状疱疹疼痛治疗阿片类药物转换中的应用。方法：选择37例住院治疗的带状疱疹疼痛患者，年龄>45 岁、VAS评分≥4分、所有病人常规抗病毒治疗、增加免疫力等常规治疗，予硬膜外腔置管间断注入消炎镇痛药物并持续泵吗啡，根据疼痛调整至止痛剂量，转换为多瑞吉贴剂后出院。疼痛控制后逐渐减药，每半个月减量半贴多瑞吉，对病人的疼痛评分、生活质量及并发症进行评估。结果：有1 例病人应药物副反应出组，其余病人硬膜外泵吗啡后均在一周左右控制疼痛，等效转换为多瑞吉，定时定量减药，无疼痛反复，成瘾戒断等情况。结论：带状疱疹疼痛采用硬膜外间断注药持续泵吗啡迅速达到无痛后，转换为等效剂量的多瑞吉，定时定量减药，安全有效。

英文摘要:

Objective: To investigate the therapeutic effect of transdermal fentanyl (Duragesic) in patients with herpes zoster neuralgia, who have administrated with other opium analgesics. Methods: Thirty-seven patients suffering from HZ pain, average age above 45-year old, VAS greater than or equal 4. All patients were treated with continuous epidural morphine infusion and intermittent injection of antiphlogistic and analgesic drugs after epidural catheterization, adjusted the dosage according to pain, and then changed to transdermal fentanyl. After pain was controlled, Duragesic was slowing deducted by half patch per half-month. The analgesic effect, the quality of life, and the side effects were observed after Duragesic used. Results: One patient stopped the fentanyl treatment because of adverse events. The pain of all the other patients were controlled well in about one week after continuous epidural morphine infusion and intermittent epidural injection. When the epidural morpine switched to equal dosage Duragesic, no patient had pain recurred, addiction or withdrawl. Conclusion: HZ pain could quickly vanish by treated with continuous epidural morphine infusion and intermittent injection after epidural catheterization. Then analgesic was changed to equivalent dose transdermal fentanyl.Duragesic could provide excellent pain relief with relatively lower side effects.

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