脊柱转移癌患者疼痛管理研究进展  

Research progress of pain management in patients with spinal metastatic tumors

作　　者：段树杰 瞿中勇 王鹏儒 李博 袁昊 许炜 Duan Shujie;Qu Zhongyong;Wang Pengru;Li Bo;Yuan Hao;Xu Wei(Department of Orthopedics,Changning County People′s Hospital of Yunnan Province,Baoshan 678100,China;Department of Orthopedic Oncology,the Second Affiliated Hospital of Naval Medical University(Shanghai Changzheng Hospital),Shanghai 200003,China)

机构地区：[1]云南省昌宁县人民医院骨科,保山678100 [2]海军军医大学第二附属医院(上海长征医院)骨肿瘤外科,上海200003

出　　处：《中华转移性肿瘤杂志》2024年第6期627-631,共5页Chinese Journal of Metastatic Cancer

摘　　要：近几十年,抗肿瘤药物的发展及外科手术技术的进步使得脊柱转移癌患者生存期显著延长,但患者常因剧烈骨痛及神经痛导致生活质量不高。恶性肿瘤转移至脊柱时不但会改变骨骼微环境,致使外周、中枢敏化及伤害感受器激活,还会使脊柱稳定性丧失、神经根受压等,出现长期剧烈的机械性疼痛及神经痛。由于脊柱转移癌患者的致痛机制复杂、镇痛手段少、用药不规范等原因导致镇痛效果欠佳,进一步导致了患者有限生存期内生活质量严重下降。本文就脊柱转移肿瘤性疼痛的产生机制及目前临床常用的有效镇痛方式进行综述,结合患者疼痛特点提出目前常用有效的镇痛方案,以期为脊柱转移癌患者疼痛管理提供治疗思路。In recent decades,with the development of anti-tumor drugs and the advancement of surgical techniques,the survival of patients with spinal metastatic tumors was significantly prolonged.However,patients often have a poor quality of life due to severe bone pain and neuralgia.The metastasis of malignant tumors to the spine not only alters the bone microenvironment,leading to peripheral and central sensitization as well as nociception activation,but also disrupts spinal stability and causes nerve root compression,resulting in prolonged severe mechanical pain and neuralgia.Due to complex pain mechanism,few analgesic methods,and non-standard medication,the analgesic effect is not ideal in patients with spinal metastases,further leading to a serious decline in the quality of life of patients during their limited survival period.This article reviews the mechanism of tumor-related pain in spinal metastases and the commonly used effective analgesic methods,and puts forward the commonly used and effective analgesic regimens considering the pain characteristics of patients,in hope of providing treatment ideas for the pain management of patients with spinal metastases.

关 键 词：脊柱转移癌 脊柱不稳 癌性骨痛 疼痛管理 

分 类 号：R73[医药卫生—肿瘤]