摘要
目的:评价强阿片类药物治疗中、重度癌痛的疗效及安全性,探讨镇痛治疗对生活质量和预后的影响。方法:应用强阿片类药物治疗伴有中、重度疼痛的恶性肿瘤患者122例,观察药物剂量、疗效、不良反应及生存期;采用生活质量量表EORTCQLQ-C30(V3.0)中文版评估66例肺癌疼痛患者镇痛前后的生活质量变化,并对不同疼痛程度和不同疼痛缓解程度癌痛患者的预后进行比较分析。结果:使用阿片类药物治疗后,中度、重度疼痛患者疼痛缓解率分别为94.9%和86.7%;与治疗前相比疼痛程度明显减低,P<0.05。治疗过程中便秘发生率47.5%、恶心呕吐11.5%、排尿困难9.0%、头晕4.9%。经镇痛治疗后91.4%的患者生活质量明显改善,尤以失眠改善最为明显。Kaplan-Meier生存分析显示,中度癌痛患者半年总疼痛治疗生存率明显优于重度疼痛者,疼痛程度与生存显著相关,P=0.000。疼痛完全缓解和明显缓解者半年总疼痛治疗生存率明显高于中度和轻度缓解者,疼痛缓解程度与生存显著相关,P=0.003。Cox多因素分析结果显示,疼痛部位和疼痛程度是影响预后的独立危险因素。结论:强阿片类药物治疗中、重度癌性疼痛是安全有效的;它能明显提高癌痛患者生存率、延长其生存期,并能提高肺癌癌痛患者的生活质量。
OBJECTIVE：To evaluate the efficacy and safety of strong opioid drugs in patients with moderate-severe cancer pain,and observe the improvement of quality of life（QOL） and prognosis.METHODS：Totally 122 cases of patients who were diagnosed with pathology were selected.All of them had complaints of pain（NRS score for moderate-severe pain）,and were treated with strong opioid.The onset time,efficacy,adverse reactions and surcival time were observed.QOL were assessed in 66 lung cancer patients,using EORTC QLQ-C30（V3.0）,as well as the different level of pain,cancer pain and pain relief in patients with different prognosis were analyzed.RESULTS：Pain in patients with moderate pain relief rate was 94.9%,and with severe pain remission rate was 86.7%.With the degree of pain before treatment was significantly lower（P0.05）.The common side effects were constipation（47.5%）,nausea and vomitting（11.5%）,dysuria（9.0%）,dizziness（4.9%）.The course of the study found no respiratory depression,mental or physical dependence on the adverse reactions.And 91.4% of patients had improved quality of life.Kaplan-Meier survival analysis showed that patients with moderate pain for six months survival rate was significantly better than the overall treatment of pain with severe pain and pain level was significantly correlated with survival（P=0.000）.Complete remission of pain and obvious pain remission for six months the total survival rate was significantly higher than moderate and mild remission,pain relief was significantly correlated with survival（P=0.003）.Cox multivariate analysis showed that the pain area and pain level is an independent prognostic risk factors.CONCLUSIONS：The strong opioid treatment of moderate and severe cancer pain is safe and effective.It markedly improved the survival rate in patients with cancer pain and prolong the survival period,and can improve the quality of life in patients with lung cancer pain.
出处
《中华肿瘤防治杂志》
CAS
2010年第22期1874-1877,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
强阿片类
癌痛
生活质量
生存期
strong opioid drugs
Cancer pain
Quality of life
Survival time
