缓解晚期妇科癌痛对患者活动能力及生活质量的影响

Impact of cancer pain relief on the ability of activities and quality of life in patients with terminal gynecologic tumors

目的:探讨使用盐酸吗啡缓释片直肠给药方式对妇科肿瘤患者癌痛的有效缓解以及对患者的活动能力和生活质量的影响。方法:1998-06/2000-12哈尔滨市中医院43例妇科肿瘤患者,病程3～23年。使用盐酸吗啡缓释片直肠给药对43例妇科肿瘤患者进行癌痛治疗,并判断疼痛症状缓解情况。对有效缓解者与无效者进行活动能力和生活质量进行比较,寻找癌痛缓解与妇科肿瘤患者活动能力和生活质量的关系。结果:给药后患者癌痛缓解率为86%,完全缓解11例,明显缓解18例,中度缓解8例,轻度及未缓解6例。癌痛缓解良好患者活动能力为:0级11例,I级18例,Ⅱ级7例,Ⅲ级1例。癌痛未缓解患者活动能力为0级0例,I级0例,Ⅱ级1例,Ⅲ级6例。方差分析显示癌痛未缓解患者在角色、社会功能、整体功能领域、经济影响、总量表得分方面的生活质量低于癌痛缓解患者,盐酸吗啡直肠给药前疼痛级数为(7.55±1.36),治疗后降为(2.27±1.83),二者相比差异有显著性意义(P<0.01)。生活质量按EORTC生活质量-C30评价,治疗前为(62.90±3.18),治疗后为(49.83±7.49),二者相比差异亦有显著性意义(P<0.01)。结论:妇科肿瘤患者癌痛的缓解对患者的活动能力和生活质量有正面效应,是改善患者生活质量和活动能力的有效途径。

AIM:To investigate the effect of rectal administration of morphine hydrochloride(slow release tablet) in significantly relieving cancer pain of patients with gynecologic tumors,and the impact of pain relief on the ability of activities and quality of life(QOL) in patients.METHODS:From June 1998 to December 2000,43 women with gynecologic tumors were selected from Harbin Hospital of Traditional Chinese Medicine,and their course ranged from 3 to 23 years.Morphine hydrochloride(slow release tablet) was rectally administrated to the 43 females to treat cancer pain followed by the judgment of pain relief.The ability of activities and QOL were compared between the pain relieved and pain unrelieved patients to explore the relationship of cancer pain relief with ability of activities and QOL in patients with gynecologic tumors.RESULTS:The rate of pain relief was 86% after administration.Complete relief of pain was found in 11 cases,remarkable in 18 cases,moderate in 8 cases,mild in 6 cases and unrelieved in 6 cases.The ability of activities in the pain relieved patients was:grade 0 in 11 cases,grade Ⅰ in 18 cases,grade Ⅱ in 7 cases and grade Ⅲ in 1 case,and in the pain unrelieved patients grade 0 was in 0 case,grade Ⅰ in 0 case,grade Ⅱ in 1 case and grade Ⅲ in 6 cases.It was shown from the analysis of variance showed that the scores for QOL of the pain unrelieved patients in terms of role,social function,whole field of function,financial influence and total scale were lower than those of pain relieved patients.The grade of pain was 7.55± 1.36 before rectal administration of morphine hydrochloride,and decreased to 2.27± 1.83 after treatment,with significant difference between them(P< 0.01).According to the EORTC Quality of Life C30 socoring,the QOL was (62.90± 3.18) points before administration,and (49.83± 7.49) points after administration,also with significant difference between them(P< 0.01).CONCLUSION:Pain relief has an active effect on the ability of activities and QOL in patients with gynecologic tumors,indicating that relief of pain is one of the effective ways for patients to improve QOL and ability of activities.