癌痛及其对癌症患者生活质量影响的调查

Cancer pain and its influence on cancer patients′ quality of life

目的 探讨癌痛及其对癌症患者生活质量的影响。方法 应用简明健康状况调查表(SF 36简表 )及简明疼痛调查表 (briefpaininventoryBPI)对 2 0 0例住院患者的癌痛情况、癌痛对其生活质量的影响及癌痛的处理进行系统的调查。结果 (1)疼痛的发生率为 6 9 0 % ,其中轻度疼痛占2 1.5 % ,中度疼痛占 19.0 % ,重度疼痛占 2 8.5 %。 (2 )中、重度疼痛患者中消化道肿瘤比例较高。 (3)疼痛与疾病分期无关 (P >0 .0 5 )。 (4)疼痛的发生与骨转移的存在密切相关 (P <0 .0 1)。 (5 )无论是轻度、中度还是重度疼痛 ,均严重影响患者的日常生活、情绪、行走能力、工作、睡眠 ,且随着疼痛程度的加重 ,影响也逐渐加深。但在对生活乐趣和社交两方面的影响上 ,中度疼痛和重度疼痛差异无显著性 (P >0 .0 5 )。 (6 )中度疼痛对患者精神状态的影响要早于重度疼痛 ,因此在癌症患者的疼痛达到中度时 ,就应在止痛治疗的同时密切配合对其心理上的治疗 ,以期达到更好的疼痛缓解。 (7)在疼痛处理上 ,未经适当处理的占 41.3% ;在重度疼痛中 ,强阿片类药物应用仅达 5 2 .1% ,与WHO要求的阶梯止痛治疗原则差距较大。结论 疼痛是影响生活质量的一个重要因素 ,而癌痛的治疗尚存在较大差距。要达到WHO提出的到 2 0 0

Objective To study cancer pain and its effect on cancer patients′ quality of life.Methods Medical Outcomes Study 36 Item Short Form Health Survey (SF 36) and Brief Pain Inventory (BPI) methods were used to investigate cancer pain, its effect on patients′ quality of life and management in 200 cancer inpatients.Results The incidence of cancer pain was 69%, including 21.5% with mild pain, 19% with moderate pain and 28.5% with severe pain. Moderate and severe pain occurred more frequently in patients with cancer of the digestive tract. No correlation was found between pain and stage of the disease, but was closely associated with bone metastasis. Regardless of its severity, cancer pain seriously affected patients general activity, mood, walking ability, normal work and sleep. With the seriousness of pain, the patients were more affected. However, there was no obvious difference between moderate and severe pain in terms of their effect on the patients′ joy of life and relations with people. The effect of moderate pain on patients′ mentality appeared earlier than did severe pain. Among patients with cancer pain, 41.3% of them did not receive proper treatment. Only 52.1% of patients with severe pain were given strong opioids, which is far from the anti pain standard set forth by the WHO.Conclusion Cancer pain is one of the most important factors which affect cancer patients′ quality of life. For adequate control of cancer pain, there is still a long way to go to achieve WHO′s goal.