癌痛规范化治疗的意义探讨  

Significance of standardized treatment for cancer pain

作　　者：李颖[1] 李欣[1] 姜达[1] 张增叶[2] 董倩[1] 

机构地区：[1]河北医科大学第四医院肿瘤内科,石家庄市050000 [2]河北医科大学第三医院肿瘤内科

出　　处：《中国肿瘤临床》2015年第12期594-599,共6页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨在癌症疼痛诊疗规范(2011年版)指导下癌痛规范化治疗的意义。方法:收集自2012年3月至2013年12月就诊于河北医科大学第四医院肿瘤内科126例癌痛患者的临床资料,比较NRS评分、爆发痛次数、生存质量影响评分3个方面改善的情况;分析不同疼痛分级、病种与治疗效果之间的关系;通过Logistic回归分析癌痛缓解的影响因素。结果:规范化治疗后NRS评分的改善率在不同疼痛分级(P=0.001)、不同性别患者间有显著性差异(P<0.001),在不同病种间无显著性差异(P=0.112);规范化治疗后生存质量影响总分下降和爆发痛次数减少的改善率各组内均差异无统计学意义。疼痛分级、病种对癌痛缓解情况影响不大。抗肿瘤治疗、无远处转移两个因素是促使NRS评分、生存质量影响评分下降的独立因素;无远处转移(P=0.046)是促使爆发痛次数减少的独立因素。结论:规范化治疗癌痛带来NRS评分、爆发痛次数、生存质量影响评分的获益;接受抗肿瘤治疗、无远处转移的患者止痛治疗效果明显。Objective：To discuss the significance of standardized treatment for cancer pain, according to the Cancer Pain Treat-ment Specification （2011 Edition） issued by the Ministry of Health, PR China. Methods：Clinical data of 126 patients with cancer pain, who were admitted to the Department of Medical Oncology, The Fourth Hospital of Hebei Medical University, were collected to com-pare the improvement of the Numeric Rating Scale （NRS） score, number of breakthrough pain, and quality of life score after treatment. The relationships between different pain grades, disease entities, and treatment effect were analyzed. The influence factors of pain relief were also analyzed by using Logistic regression analysis. Results：1）. Following standardized treatment, the improvement rate of NRS score has shown significant differences in pain grading （P=0.001） and gender （P=0.000）. However, no significant differences were ob-served between different diseases （P=0.112）. The improvement rate of the life quality score and the number of breakthrough pain had no significant difference after standardized treatment. 2）. The grading of cancer pain and the disease entities had little effect on cancer pain relief. 3）. The anti-tumor treatment and“no distant metastasis”were the independent factors that brought about the decrease in NRS and quality of life scores.“No distant metastasis”（P=0.046） was the independent factor that reduced the number of pain out-breaks. Conclusion： The standardized treatment positively affects the NRS score, number of breakthrough pain, and quality of life score. Patients who received anti-neoplastic therapy and who had no distant metastasis showed significant treatment effectiveness in pain management.

关 键 词：癌症 疼痛 镇痛 阿片类 

分 类 号：R730.5[医药卫生—肿瘤]