Opioid-induced bowel dysfunction: prevalence, pathophysiology and burden.
Opioid-induced bowel dysfunction: prevalence, pathophysiology and burden.
复制标题
阿片类药物引起的肠功能障碍：患病率，病理生理和负担。
DOI：
10.1111/j.1742-1241.2007.01415.x
复制
发表时间：
2007-07
影响因子：
2.6
通讯作者：
Wurzelmann, J I
中科院分区：
文献类型：
--
作者：
Panchal, S J;Muller-Schwefe, P;Wurzelmann, J I
由于阿片类药物对胃肠道（GI）的不良作用，接受阿片类药物治疗慢性疼痛的患者通常会出现阿片类药物诱导的肠功能障碍（OBD），其最常见和最令人衰弱的症状是便秘。基于临床经验和全面的MEDLINE文献综述，本文为初级保健医生提供了OBD患病率、病理生理学和负担的概述。OBD患者患有多种症状，包括便秘、胃排空减少、腹部绞痛、痉挛、腹胀、胃肠道传输延迟和硬干便的形成。OBD可能对生活质量（QoL）和患者感觉能够进行的日常活动产生严重的负面影响。为了缓解与OBD相关的便秘，患者经常长期使用泻药（与风险相关）或改变/放弃阿片类药物，可能会牺牲镇痛。医生应该对OBD的患病率、症状和负担有更多的了解。鉴于OBD可能对生活质量产生严重的负面影响，医生应鼓励与患者对话，以促进病情的最佳对症治疗。迫切需要新的疗法，作用于OBD的潜在机制。
As a result of the undesired action of opioids on the gastrointestinal (GI) tract, patients receiving opioid medication for chronic pain often experience opioid-induced bowel dysfunction (OBD), the most common and debilitating symptom of which is constipation. Based on clinical experience and a comprehensive MEDLINE literature review, this paper provides the primary care physician with an overview of the prevalence, pathophysiology and burden of OBD. Patients with OBD suffer from a wide range of symptoms including constipation, decreased gastric emptying, abdominal cramping, spasm, bloating, delayed GI transit and the formation of hard dry stools. OBD can have a serious negative impact on quality of life (QoL) and the daily activities that patients feel able to perform. To relieve constipation associated with OBD, patients often use laxatives chronically (associated with risks) or alter/abandon their opioid medication, potentially sacrificing analgesia. Physicians should have greater appreciation of the prevalence, symptoms and burden of OBD. In light of the serious negative impact OBD can have on QoL, physicians should encourage dialogue with patients to facilitate optimal symptomatic management of the condition. There is a pressing need for new therapies that act upon the underlying mechanisms of OBD.