小儿实体恶性肿瘤疼痛治疗的临床研究

THE CLINICAL ANALYSIS OF THE PAIN TREATMENT OF CHILDREN WITH SOLID MALIGNANT TUMORS

目的:研究不同年龄段小儿实体恶性肿瘤疼痛治疗方法与效果。方法:选择68例实体恶性肿瘤患儿,根据患儿的年龄、体重、临床表现,轻度疼痛使用吲哚美辛栓剂2mg/kg.d-1,分3次塞肛,中度疼痛每次口服盐酸曲马多胶囊2.0mg/kg,观察镇痛治疗前后患儿疼痛评分和生命体征变化,不同年龄段及不同病种患儿使用镇痛药物情况,手术和非手术患儿使用镇痛药物情况,分析治疗后出现的不良反应。结果:<3岁患儿使用镇痛药物比例明显高于>4岁患儿(P<0.05);术后化放疗的患儿使用镇痛药物比例明显高于手术后患儿(P<0.05);治疗后的主要不良反应有:头昏、嗜睡、便秘、恶心呕吐等。结论:小儿实体恶性肿瘤中肝母细胞瘤引起的疼痛最严重,且术后化放疗引起的疼痛较手术后疼痛更加剧烈;不同年龄和不同疼痛程度的患儿应选用不同的镇痛药物和镇痛方法。

Objective： To investigate the method and effect of analgesic drugs in pediatric solid malignant tumors of different ages. Methods：Sixty-eight cases in our hospital with solid malignant tumors in children, according to children＇s age, weight, clinical manifestations, pain response, indomethacin suppository 2 mg/ kg per time, anal medication into 3 times for mild pain, intramuscular oral tramadol capsule 2 mg/kg · time^-1 for moderate pain,analysis the pain score and vital sign in children before and after analgesia treatment, and the situation of using analgesic drugs in children with different diseases and different ages, the relationship between analgesic drugs used by surgery and by postoperative plus chemoradiotherapy and the major adverse reactions after using analgesic drugs. Results： The application rate of analgesic drugs in G3- year-old children was significantly higher than that in ）4 years children（ P G0.05） ;the application rate of analgesic was higher in postoperative plus chemoradiotherapy than after surgery （ P G0.05）, adverse reactions are： dizainess and drowsiness, constipation, nausea and vomiting. Conclusion： It is the worst pain which induced by solid malignant tumors in children, especially hepatoblastoma, the pain in postoperative plus chemoradiotherapy is more severe;different analgesic drugs and method should be used with different ages and different levels of cancer pain in children.