165例骨转移癌的临床分析

Clinical Analysis of 165 Cases with Metastatic Carcinoma of Bone

目的:探讨骨转移癌患者的临床特点及止痛效果,提高诊断及治疗水平。方法:回顾性分析165例骨转移癌患者的临床资料观察近期疗效。结果:165例骨转移癌患者的发病年龄为20岁～90岁,中位年龄58岁,男女比值为1.5:1,族别以汉族及维吾尔族居多,汉族患者出现转移部位的疼痛比率低于维族患者,P<0.05,差异有统计学意义。近半数(44.24%)在确诊原发灶及治疗前已有骨转移。肺癌出现骨转移的时间最早,中位时间6月,原发灶较多的有:肺癌(34.54%)、前列腺癌(10.9%)、乳腺癌(9.7%)、宫颈癌(7.27%)、肝癌(6.67%)。全身多发转移占74.54%。转移部位以脊柱、骨盆、肋骨等部位多见,分别占80.6%、26.06%、19.39%,其中89.7%的患者有骨痛症状,少数表现为脊髓压迫、截瘫、病理性骨折。经过多因素分析发现,治疗方式是止痛效果的影响因素,联合治疗较其他治疗方式相比,P<0.05,有统计学意义。结论:165例骨转移癌患者中以汉族及维族多见,且宫颈癌在原发灶中占有较大的比例,汉族患者对疼痛的耐受性较维族患者好,骨转移癌影响患者生活质量,联合治疗方式的止痛效果好,改善患者生活质量。

Objective：To analyze the epidemiologic and clinical features of metastatic bone tumor.Methods： 165 cases with clinical diagnosis of metastatic bone admitted from several aspects.Results;Men were 1.5 times more commonly affected than women.It occurred frequently at the age 20～90,the median age is 58.The individual nationality,with the majority Han and Uygur,Han patients with ratio is lower than the Uygur,P 0.05.Nearly half（44.24%） of them had have bone metastases before the primary tumor was diagnosis and treatment.The top five common metastases were lung cancer（34.54%）,prostate cancer（10.9%）,breast cancer（9.7%）,cervical cancer（7.27%）,liver cancer（6.67%）.Systemic multiple metastases accounted for 74.54%.The spine,pelvis and rib were the most common metastatic sites.The main symptom was pain（89.7%）.after multivariate analysis, treatment effect is the pain factor,combination therapy compared with other forms of treatment,P 0.05.Conclusion： In 165 cases of metastatic bone cancer patients;the Han and Uygur were common in bone metastases cancer. The study indicates that cervical cancer was account for a proportion of patients in the primary tumors.Han patients with pain tolerance were better than Uygur.Bone metastases affect the quality of life,combination therapy of pain was better.