康复治疗缓解晚期癌症患者疼痛症状及对生活质量的影响  

Effects of rehabilitation therapy in relieving pain and improving quality of life in patients with advanced cancer

作　　者：张彤[1] 常学民[1] 何予功[1] 黄红霞[2] 范奎生[3] 

机构地区：[1]郑州大学第一附属医院康复医学科,河南省郑州市450052 [2]平舆县人民医院康复科,河南省平舆县463400 [3]郑州大学第一附属医院肿瘤科,河南省郑州市450052

出　　处：《中国临床康复》2005年第40期59-61,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:观察综合性康复治疗配合肿瘤科常规治疗对晚期癌痛患者的疼痛强度和生活质量的影响。方法:纳入2001-03/2004-12郑州大学第一附属医院肿瘤科住院晚期癌症患者152例,男96,女56例,35～72岁,平均(48±14.7)岁。按随机抽签法分为观察组73例和对照组79例。两组患者均给予肿瘤科常规治疗,患者生命体征稳定。对照组采用WHO推荐世界疼痛学会所提出的“癌性疼痛三级阶梯治疗方案”;观察组联合综合性康复治疗(运动疗法、物理治疗、放松及暗示训练、心理治疗)。按照WHO推荐视觉模拟评分方法评估,采用0～10数字进行镇痛强度分级,完全无痛为0分,难以忍受疼痛为10分;镇痛疗效评定:6～10分为镇痛无效,3～5分为镇痛有效,0～2分为镇痛效果佳;生活质量评估参考国内1990年制定的肿瘤患者生存质量评分草案,由患者对康复治疗或药物治疗镇痛前后的食欲、睡眠、日常生活、精神状态、情绪、与人交往、生活乐趣等进行自我评估(以0～10分表示,0分为无干扰,10分为极度干扰。)。观察两组治疗1个月前后的疼痛强度、生活质量评分的变化和不同治疗的不良反应。结果:参与观察的住院晚期癌症患者152例全部进入结果分析。①治疗后,观察组和对照组患者疼痛评分均明显低于治疗前(2.70±1.91,8.90±1.73,t=3.657,P<0.01;4.60±1.83,9.20±1.50,t=2.132,P<0.05),且观察组显著低于对照组(t=2.631,P<0.01)。②治疗后,观察组患者食欲、睡眠、日常生活、精神状态、情绪、与人交往、生活乐趣评分均明显低于对照组(4.67±1.23,5.86±0.45;4.62±0.73,5.45±1.31;4.92±0.50,5.01±0.67;4.81±0.61,5.70±1.02;4.64±1.26,5.40±0.52;4.61±0.63,5.61±0.47;4.84±1.59,5.50±0.38;t=2.652,2.731,2.807,2.931,2.841,2.874,2.933,P<0.01)。③康复观察组没有明显的不良事件和副反应。三阶梯组有明显的不良反应,如恶心、呕吐、皮肤瘙痒、尿潴留、便秘和呼吸抑制AIM： To observe the effects of comprehensive rehabilitation therapy integrated with routine therapy of department of oncology on intensity of pains and quality of life in patients with advanced cancer pain. METHODS： 152 advanced cancer patients, who were treated at Department of Oncology, First Affiliated Hospital, Zhengzhou University from March 2001 to December 2004, were selected, including 96 males and 56 females, aged 35 to 72 （mean 48±14.7） years. They were assigned into observation group with 73 cases and control group with 79 cases by randomized drawing method. All the patients were treated with routine therapy at department of oncology with stable vital signs. Three steps therapy method for cancer pain suggested by world association for the study of pain and recommended by WHO were used in patients from the control group. Those in the observation group integrated treated with comprehensive rehabilitative therapy （cinesiateics, physiotherapy, relax, suggestion training and psychological treatment）. Visual analogous scale （VAS） suggested by WHO was used to assess. Analgesia intensity expressed with 0-10, 0 point as without pain completely, 10 points as unbearable pain; Evaluation of analgesia effect： 6-10 points as ineffective analgesia, 3-5 points as effective analgesia, 0-2 points as optimal analgesia; The quality of life was evaluated with living quality draft for oncology patients designed in 1990. Appetite, sleeping, daily life, mental status, emotion, human communication and living pleasure, etc. during rehabilitative therapy or drug therapy before and after analgesia were assessed by the patients selves （using 0-10 points, 0 point as non-intervention, 10 points as severe intervention）. Changes of scores on pain intensity and quality of life with side effects of different therapy were observed in the two groups before and after one month. RESULTS： 152 advanced cancer patients who joined the observation were all involved in the result analysis. ① After therapy, scores on pai

关 键 词：生活质量 疼痛/治疗 镇痛 病人控制 肿瘤/并发症 

分 类 号：R395.13[哲学宗教—心理学]