Abstract：
Myoclonus is a relatively rare involuntary movement that is often observed in palliative care settings and that can cause patient distress. The purpose of this study is to investigate the occurrence of myoclonus and countermeasures against it in terminally ill patients with cancer diagnosed by palliative care specialists at Komaki City Hospital, Japan. We retrospectively reviewed patients with terminal cancer who received palliative care consultations between January 2018 and May 2019 and who were diagnosed with myoclonus by palliative care specialists, using electronic medical records. Patient demographics, time from onset of myoclonus to death, daily opioid use, countermeasures, and outcome of myoclonus were assessed. Of 360 patients examined during this period, 45 (12.5%) were diagnosed with myoclonus. Median age was 71 (range, 43-88) years; median time from onset of myoclonus to death was 8 days (range, 0-56); opioid usage was present in 39 patients (morphine, oxycodone, and fentanyl: n = 6, 21, and 12, respectively); and median oral morphine equivalent at onset of myoclonus was 60 mg (range, 12-336 mg). Myoclonus treatment was administered to 21 patients (opioid dose reduction, opioid switching, and others: n = 14, 3, and 4, respectively). Myoclonus is a common complication in patients with terminal cancer.
摘要：
肌阵鸣是一种相对罕见的非自愿运动，通常在姑息治疗环境中观察到，并可能导致患者痛苦。目的探讨小卷市医院姑息治疗专家诊断的癌症绝症患者肌阵挛症的发生情况及对策,日本。我们回顾性分析了在2018年1月至2019年5月期间接受姑息治疗咨询并被姑息治疗专家诊断为肌阵挛症的晚期癌症患者。使用电子病历。患者人口统计学，从肌阵鸣发作到死亡的时间，每日使用阿片类药物，对策,并对肌阵挛症的结局进行了评估。在此期间检查的360名患者中，45例（12.5％）被诊断为肌阵挛症。中位年龄为71岁(范围，43-88）年；从肌阵挛症发作到死亡的中位时间为8天（范围，0-56)；39例患者使用阿片类药物(吗啡，羟考酮,和芬太尼：分别为6、21和12）；肌阵挛症发作时的中位口服吗啡当量为60mg（范围，12-336毫克）。对21例患者进行了肌阵鸣治疗(阿片类药物剂量减少，阿片类药物转换，和其他：n=14，3和4，分别）。肌阵挛症是晚期癌症患者的常见并发症。
