非药物干预措施对晚期肿瘤患者癌性疼痛控制及睡眠质量的影响

Effects of non-pharmaceutical interventions on cancer pain control and sleep quality in patients with advanced tumors

目的探讨非药物干预措施在晚期癌症患者癌性疼痛控制中的应用效果。方法选择2017年7月—2019年6月南京医科大学附属淮安第一医院收治的晚期肿瘤患者92例,采用随机数字表法分为试验组48例,对照组44例。对照组根据癌症三阶梯止痛原则进行止痛护理,试验组在对照组基础上联合应用非药物干预措施。随访3个月,采用视觉模拟疼痛评分(VAS)、匹兹堡睡眠质量指数(PSQI)、癌症患者生命质量通用量表(FACT-G)评估疼痛程度、睡眠质量、生活质量。结果随访3个月,两组患者VAS评分均明显下降,差异有统计学意义(P<0.05),试验组VAS评分低于对照组,差异有统计学意义(P<0.05)。两组患者中重度疼痛发生率均明显下降,差异有统计学意义(P<0.05),试验组中重度疼痛发生率低于对照组,差异有统计学意义(P<0.05或P<0.01)。两组患者PSQI各因子评分及总分均较干预前明显下降,差异有统计学意义(P<0.05);试验组睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能及PSQI总分均低于对照组,差异有统计学意义(P<0.05),两组患者催眠药物评分比较,差异无统计学意义(P>0.05)。两组患者FACT-G各维度评分及总分均较干预前明显升高,差异有高度统计学意义(P<0.01),试验组生理状况、功能状况、情感状况、社会家庭状况及FACT-G总分高于对照组,差异有高度统计学意义(P<0.01)。结论非药物干预有助于缓解晚期肿瘤患者癌性疼痛程度,改善睡眠质量与生活质量。

Objective To explore the application effect of non-pharmaceutical interventions in the control of cancer pain in patients with advanced cancer.Methods From July 2017 to June 2019,a total of 92 patients with advanced tumors admitted to Huai’an First Hospital Affiliated to Nanjing Medical University were selected and divided into 48 cases in the experimental group and 44 cases in the control group by random number table method.The control group was given analgesic care based on the principle of three steps of cancer pain relief,and the experimental group was combined with non-drug interventions on the basis of the control group.Followed up for three months,the visual analogue scale(VAS),pittsburgh sleep quality index(PSQI),and the general quality of life scale for cancer patients(FACT-G)were used to assess the degree of pain,sleep quality,and quality of life.Results After three months of follow-up,the VAS scores of the two groups were decreased significantly,and the differences were statistically significant(P<0.05).The VAS score of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).The incidence of moderate and severe pain in the two groups were decreased significantly,and the differences were statistically significant(P<0.05).The incidence of moderate and severe pain in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05 or P<0.01).The PSQI scores and total scores of the two groups were significantly lower than those before the intervention,and the differences were statistically significant(P<0.05);the sleep quality,time to fall asleep,sleep time,sleep efficiency,sleep disturbance,daytime function and PSQI total scores of the experimental group were lower than those of the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the hypnotic drug scores between the two groups(P>0.05).The FACT-G scores and total scores of the two groups were significantly higher than those before the intervention,and the differences were highly statistically significant(P<0.01).The physiological status,functional status,emotional status,social and family status and FACT-G total score of the experimental group were higher than those of the control group,and the differences were highly statistically significant(P<0.01).Conclusion Non-pharmaceutical intervention can help relieve cancer pain in patients with advanced tumors,and improve sleep quality and quality of life.