ea e ia ?oeao aieuiuo, iu ni?ee iaiaoiaeiui iiaaeeouny iiu-
oii eniieuciaaiey iaiiai ec ieo.
A aaiiie ?aaioa i?aanoaaeaiu ?acoeuoaou aiaoeaoi?iiai
i?eiaiaiey i?aia?aoa MST-nontinuus oe?iu «Mundipharma».
I?aia?ao aue eniieuciaai a oi?ia oaaeaoie ii 10, 30, 60 e 100
ia aey ea?aiey o?iie?aneiai aieaaiai neia?iia o 68 iieieiae-
?aneeo aieuiuo IV eeeie?aneie a?oiiu. A yoo a?oiio aioee aieu-
iua ?aeii iiei?iie ?aeacu (23), ?aeii eaaeiai (8), n na?eiiie
iyaeeo oeaiae (7), n iaeaiiiie (4), n aeia?iao?iiie (6), ?aeii
io?neeo iieiauo i?aaiia (7), ?aeii oienoie eeoee (6), na?ei-
iie einoae (2), ?aeii oaea iaoee (3) e ii iaiiio aieuiiio ?a-
eii iiniaeioee e eeioia?aioeaiaoicii n ii?a?aieai einoae.
Aieaaie neia?ii aue iaoneiaeai aieaa ?ai o iieiaeiu iaoeai-
oia (42) iaoanoaoe?aneei eee ia?ae?iui ii?a?aieai einoae
neaeaoa, a o inoaeuiuo — ia?ae?iui eee iaoanoaoe?aneei ii?a-
?aieai iyaeeo oeaiae eee aioo?aiieo i?aaiia. Iineieueo i?a-
ia?ao iaeaaaao i?ieiiae?iaaiiui aaenoaeai, oi e i?eai aai
inouanoaeyeny ?a?ac 12 ?., o.a. 2-3 ?aca a nooee. Neea aiee ai ea-
?aiey ioaieaaeanu ii aecoaeuiie aiaeiaiaie oeaea (AAO) a
aaeieoao io 0 (iao aiee) ai 100 (naiay neeuiay, iaauiineiay
aieu). Yoa nenoaia ioaiee eioaineaiinoe eee neeu aiee aieaai-
ai neia?iia i?eiaiyaony a aieuoeinoaa ca?oaa?iuo eeeiee e
aa eniieuciaaiea a aaiiii enneaaiaaiee iicaieeei aaaeaaoii
n?aaieou iaoe ?acoeuoaou n eia?ueieny a iiiai?eneaiiuo ee-
oa?aoo?iuo enoi?ieeao. Eioaineaiinou aiee o iaoeo iaoeaioia
eieaaaeanu io 55 ai 90 aaeieo ii AAO.
Ana aieuiua ai ia?aea ea?aiey MST-nontinuus iieo?aee ioa-
?anoaaiiua ia?eioe?aneea aiaeuaa-oeee, eioi?ua auee eee ia-
eiyooaeoeaiu, eee o?aaiaaee neeoeii ?anoiai eo i?eiaiaiey,
?oi inei?iyeinu ec-ca ia?aioa?aeuiiai eo aaaaaiey eee ec-ca eo
ia?aie?aiiiai eiee?anoaa.
A oiaa i?iaiaeiiai ea?aiey 4 aieuiuo ioeacaeenu io MST-
nontinuus ec-ca ?acaeaoaeny iaoe?ioeiie ?aiou iinea iaii- eee
aaoe?aoiiai i?eaia, ianiio?y ia ?aeiiaiaaoee i?eiaiaiey ai-
oeaiaoeeia. Yoe aieuiua auee a ?enea ia?auo, eiaaa iu aua ia
ia?aee iacia?aou i?ioeeaeoe?anee i?ioeai?aioiua i?aia?aou. A
aaeuiaeoai anai aieuiui ?aeiiaiaiaaeinu i?eieiaou ai-
oeaiaoeee. Ie?a iaie i?aanoaaeaiu ?acoeuoaou ea?aiey o?iie-
?aneiai aieaaiai neia?iia o 64 iieieiae?aneeo aieuiuo, iaoi-
aeaoeony a oa?ieiaeuiie noaaee caaieaaaiey e iieo?aaoeo ii-
eiioaiiia i?ioeaiaieaaia ea?aiea. A yoie a?oiia i?aia?ao ii-
eo?aee ai naiie nia?oe 47 aieuiuo. O inoaeuiuo i?eai aue i?a-
e?auai a nayce n ionoonoaeai i?aia?aoa e yoeo aieuiuo ia?aaa-
ee ia eiaaoeany a eo ?anii?y?aiee ioa?anoaaiiua iieieau. A
i?ioanna ea?aiey auei onoaiiaeaii, ?oi i?aia?ao yaeyaony au-
nieiyooaeoeaiui aiaeuaaoeeii, i?iaaiiino?e?iaaaoei i?ae-
oe?anee 100% yooaeo o 51 (79,7%) aieuiiai. O 6 aieuiuo o?iaaiu
nie?aiey aiee eieaaaeny ii AAO io 10 ai 20 aaeieo o 3 e ai 30
aaeieo o 3, ?oi aiieia oaiaeaoai?yei iaoeaioia. Nooi?iay aica
MST Continuus eieaaaeanu a caaeneiinoe io enoi?ieea e neeu ai-
ee, eiaeaeaoaeuiie ?oanoaeoaeuiinoe e ia?aiineiinoe i?aia?a-
oa. Aeaiacii eieaaaiee aue ainoaoi?ii aaeee — io 20 ai 1080 ia.
N?aaiyy nooi?iay aica ninoaaeea 270 ia. Aaee?eia nooi?iie ai-
cu niioaaonoaiaaea eia?ueiny eeoa?aoo?iui aaiiui, iie?a?-
ueiny ia ia?aoia?iaiue iiuo eniieuciaaiey aaiiiai i?aia?a-
oa: 20-1200 ia [4], 40-540 ia [C], 5-3165 ia [2]. I?iaie?eoaeuiinou
ea?aiey a iaoai enneaaiaaiee eieaaaeanu io 4 ai 192 aiae, a
n?aaiai — 72 aiy. I?eciaeia ?acaeoey ineoieiae?aneie caaene-
iinoe, a oae?a no?aieaiey e aaneiio?ieuiiio oiio?aaeaie?
i?aia?aoa n?aae iaoeo iaoeaioia ioia?aii ia auei.
Aac iiai?iiai aaenoaey i?iea?aiu 26 aieuiuo, o inoaeuiuo
iiai?iue yooaeo aue neaaui e eoie?iaaeny i?eaiii niioaaono-
ao?ueo i?aia?aoia eee i?ioiaee ?a?ac 3-7 aiae aac i?eaia aau-
?aaioiuo eaea?noa. A ?enea iiai?iuo i?iyaeaiee iaae?aaeenu:
oioiioa-21, ?aioa-3, caii?u-19, nooinou ai ?oo, ?a?aa-9, aeia?a-
iey ei?iuo iie?iaia-2, niieeainou-8, aaee?oeiaoee-1. Iineaa-
iea aaa neiioiia i?ioiaeee n?aco ?a iinea nie?aiey ?aciaie e
nooi?iie aicu ia 25-30%. Ca?aaeno?e?iaaiiua iaie iiai?iua
i?iyaeaiey e eo ?anoioa niioaaonoao?o aaiiui eeoa?aoo?u [3].
Noiie?oy ana auoaecei?aiiia, iu ioia?aai, ?oi i?aia?ao
MST-nontinuus, i?aanoaaeaiiue oe?iie «Mundipharma», yaeyaony
aunieiyooaeoeaiui aiaeuaaoeeii, oi?ioi ca?aeiiaiaiaaaoei
naay i?e ea?aiee o?iie?aneiai aieaaiai neia?iia o iieieiae?an-
eeo aieuiuo IV eeeie?aneie a?oiiu. I?aia?ao aeaaiaa?y oaaeaoe-
?iaaiiie eaea?noaaiiie oi?ia e i?ieiiae?iaaiiiio aaenoae?
oaiaai a i?eiaiaiee o aaiiiai eiioeiaaioa aieuiuo, eioi?ua a in-
iiaiie ianna iieo?a?o ea?aiea a aiiaoieo eee aiaoeaoi?iuo on-
eiaeyo. Iiai?iua i?iyaeaiey eaaei eoie?o?ony eee i?aaoi?a?aa-
?ony. Iaii ec iaeaieaa cia?eiuo inei?iaiee i?e eniieuciaaiee
iieieaia — oaiaoaiea auoaiey — iaie ioia?aii ia auei.
I?eiaiaiea i?aeuiuo i?aia?aoia ii?oeia i?e ea?aiee o?i-
ie?aneie aiee o eieo?aaaeuiuo aieuiuo n ea?aui aiaii iieo?a-
ao ana aieuoaa ?ani?ino?aiaiea. Oai ia iaiaa auneacuaa?ony
iianaiey eae n?aae iaaeoeineiai ia?niiaea, oae e n?aae aieu-
iuo e eo ?ianoaaiieeia a nayce n aicii?iinou? ?acaeoey ?yaa
inei?iaiee i?e eniieuciaaiee, a ?anoiinoe, MST-niitinuus. Ia-
?aoia?iaiue iiuo naeaaoaeunoaoao, ?oi i?e aaaeaaoiie aice?ia-
ea i?aeuii i?eiaiyaiue ii?oei yaeyaony yooaeoeaiui aiaeu-
aaoeeii, ia eia?uei «iioiei?iiai i?aaaeuiiai yooaeoa». Aa-
?iyoiinou ?acaeoey ineoieiae?aneie caaeneiinoe ie?oi?ii ia-
ea. ?acaeoea oiea?aioiinoe e i?aeuiiio ii?oeio i?e ea?aiee
o?iie?aneie aiee o iieieiae?aneeo aieuiuo, eae i?aaeei, auno-
?uie oaiiaie ia i?ienoiaeo, ?oi neaaoao ?anoaieaaou eae oece-
ieiae?aneo? aeeeeiaoecaoe?, eioi?ay o?aaoao oaaee?aiey aicu
eaea?noaa aey iiaaa??aiey oiai ?a ea?aaiiai yooaeoa. Eae i?a-
aeei, iacia?aaiua ia?aeeaeuii n i?eaiii ii?oeia i?ioeai-
?aioiua i?aia?aou iicaiey?o i?aaoi?aaeou oioiioo e ?aioo, e
iau?ii eo ii?ii ioiaieou ?a?ac ianeieuei aiae e aaeaa i?iaie-
?eou i?eai oieuei iieoiiuo aiaeuaaoeeia. O aieuiuo, aeeoaeu-
iia a?aiy iieo?a?ueo iieoiio? oa?aie?, iaae?aa?ony caii-
?u; oianoiui i?aanoaaeyaony i?ioeeaeoe?aneia iacia?aiea
neaaeoaeuiuo n?aanoa, oaeeo, eae oaaeaoee Senokot, ec ?an?aoa ia
ea?aua 30 ia MST Continuus iaia oaaeaoea neaaeoaeuiiai ai ia-
eneiaeuiie nooi?iie aicu 8 oaaeaoie. I?aeuiue i?eai ii?oeia
i?aaii?oeoaeai, oae eae yoi iaeaieaa oaiaii, ia naycaii n aieac-
iaiiuie iuouaieyie io eiuaeoee, ?oi i?eaaao aieuiiio aieu-
oa iacaaeneiinoe, aicii?iinoe naiieiio?iey e iiauoaao ea?a-
noai ?ecie ia oieuei aai, ii e aai ?ianoaaiieeia e a?ocae.
Ëèòåðàòóðà
1. Îáåçáîëèâàíèå ïðè ðàêå, ÂÎÇ, Æåíåâà. — 1989.
2. Coyle N. et.al. Character of Terminal Illness in the Advanced
Cancer Patient: Pain and Other Symptoms During the Last
Four Weeks of Life // Journal of Pain and Symptom Manage-
ment. — 1990. — 5 (2). — P. 83-93.
3. Zenz M. Role of morphine and other opiates in chronic pain //
The International Symposium on Pain Control: Toronto,
Canada. — 1984. — P. 39-41.
4. Sorge J. Oral morphine in cancer pain-limited by developing
tolerance? // 2-nd International Symposium «Supportive Care
in Cancer Patients": St. Gallen. — 1990. — P. 32.
5. Enck R.E. Understanding tolerance, physical dependence and
addiction in the use of opioid analgesics // The American Jour-
nal of Hospice & Palliative Care. — January/February 1991. —
P. 9-11.
6. Friedman D.P. Perspectives on the Medical Use of Drugs of
Abuse// Journal of Pain and Symptom Management. — 1990.
— 5 (l). — P. 2-5.
Iaeeeaoeaiay iaaeoeia e ?aaaeeeoaoey, 1997, ¹1, no?. 12-15.
ÏÅÐÂÛÉ ÎÏÛÒ ÈÑÏÎËÜÇÎÂÀÍÈß
ÄÈÃÈÄÐÎÊÎÄÅÈÍÀ ÏÐÎËÎÍÃÈÐÎÂÀÍÍÎÃÎ
ÄÅÉÑÒÂÈß Â ËÅ×ÅÍÈÈ ÕÐÎÍÈ×ÅÑÊÎÉ
ÁÎËÈ Ó ÎÍÊÎËÎÃÈ×ÅÑÊÈÕ ÁÎËÜÍÛÕ
A.A. A?oaiiaa, A.A. A??caei, ?.I. No?aeeiaa
Iieieiae?aneee iao?iue oaio? eiaie I.I. Aeioeia ?AII
Eiaaei aia?aea aue iieo?ai ec oe?iceia, iic?a — ec ii?-
oey. A ianoiyuaa a?aiy ai 90% eiio?iee?oaiiai i?iecaianoaa
125
Àíòîëîãèÿ íàó÷íûõ ïóáëèêàöèé
