阿片类药物对肺癌疼痛患者心理状态影响的研究  

Study of the opioids drugs effect in psychological state of patients with lung cancer-related pain

作　　者：沈陆斐[1] 陈文宇[1] 吕晓东[1] 刘加良[1] 杨新妹[2] 姚明[3] 倪华栋[3] 

机构地区：[1]浙江省嘉兴市第一医院嘉兴学院附属第一医院呼吸科,浙江嘉兴314000 [2]浙江省嘉兴市第一医院肿瘤科,浙江嘉兴314000 [3]浙江省嘉兴市第一医院疼痛科,浙江嘉兴314000

出　　处：《中国现代医生》2016年第5期9-12,共4页China Modern Doctor

基　　金：浙江省医学会临床科研基金项目(2013ZYC-A89);浙江省医药卫生科技计划项目(2015KYA217);浙江省嘉兴市科技计划项目(2014AY21030-4);浙江省嘉兴市重点学科呼吸科(04-Z-11)、肿瘤科(04-F-14)建设项目[嘉市卫发(2014)72号]

摘　　要：目的探讨阿片类药物对肺癌疼痛患者心理状态的影响。方法选取2010年8月~2015年1月间收治的200例初治肺癌疼痛患者作为研究对象,所有患者均给予阿片类药物治疗,2个月后对治疗前后患者的疼痛程度（VAS）、心理健康程度（SCL90）、焦虑程度（SAS）、抑郁程度（SDS）评分进行比较,同时分析心理状态变化的影响因素。结果镇痛治疗前,200例肺癌疼痛患者的SCL-90、SAS、SDS评分均高于国内常模（t=13.55、8.37、5.46,P〈0.01）。Logistic多因素回归分析,其心理状态的主要影响因素为癌痛程度、患者的文化程度、病程、患者家属支持及对癌性疼痛的了解程度。经2个月的镇痛治疗后,患者的VAS、SCL-90、SAS及SDS等评分均较治疗前有所改善（t=11.28、22.31、9.66、7.52,P〈0.05或P〈0.01）,但SCL-90、SAS、SDS评分仍高于国内常模（t=10.92、3.18、6.25,P〈0.01）。Logistic多因素回归分析,其心理状态的主要影响因素是其他不适症状、对药物副反应的担心、经济因素及文化程度。结论肺癌疼痛患者普遍存在抑郁、焦虑等不良心理状态,阿片类药物可以有效缓解疼痛程度,并在一定程度上改善患者的心理状态。Objective To explore the opioids drugs effect in psychological state of patients with lung cancer-related pain. Methods Initial treatment of 200 patients with lung cancer-related pain was opioids drugs,the pain sensation,mental health. anxiety and depression of all cases before treatment and after treatment were tested by VAS, SCL90,SAS, SDS after two mouths, and the influencing factors were also analyzed. Results 200 cases scores of SCL90,SAS,SDS were significantly higher than the domestic norm before treatment（t=13.55, 8.37, 5.46, P〈0.01）, the main influence factors were pain sensation,education,course of disease and family support and understanding of cancer pain. The scores of VAS,SCL90,SAS,SDS were significantly improved（t=11.28, 22.31, 9.66, 7.52, P〈0.05 or P〈0.01） after two months of treatment, but scores of SCL90, SAS, SDS were still significantly higher than the domestic norm（t=10.92,3.18, 6.25, P〈0.01）, and the main influence factors were other symptoms, worried about the side effects of medicine,economic and education. Conclusion Patients with lung cancer-related pain are usually accompanied with bad emotions,such as depression or anxiety. Opioids drugs therapy could effectively alleviate the pain,and to some extent improve patients＇ mental state.

关 键 词：肺癌 癌痛 阿片类药物 心理状态 抑郁 焦虑 

分 类 号：R730.55[医药卫生—肿瘤]