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癌痛规范化治疗提高中重度癌痛患者生活质量的临床及护理分析
Efficacy of standardized cancer pain treatment for improving quality of life in patients with severe cancer pain
- 第三军医大学学报 2018年40卷第10期 页码：934-938
- 作者机构：
400042 重庆，陆军军医大学(第三军医大学)第三附属医院(野战外科研究所)肿瘤中心
- 作者简介：
[刘红, E-mail: 1582570499@qq.com LIU Hong, E-mail: 1582570499@qq.com
- 基金信息：
DOI：10.16016/j.1000-5404.201711131
中图分类号： R181.32; R441.1; R473.73收稿：2017-11-16，
修回：2018-03-19，
纸质出版：2018-05-30
- 稿件说明：
移动端阅览
刘红, 蒋远静, 刘水霞. 癌痛规范化治疗提高中重度癌痛患者生活质量的临床及护理分析[J]. 第三军医大学学报, 2018,40(10):934-938.
Hong LIU, Yuanjing JIANG, Shuixia LIU. Efficacy of standardized cancer pain treatment for improving quality of life in patients with severe cancer pain[J]. Journal of Third Military Medical University, 2018, 40(10): 934-938.
刘红, 蒋远静, 刘水霞. 癌痛规范化治疗提高中重度癌痛患者生活质量的临床及护理分析[J]. 第三军医大学学报, 2018,40(10):934-938. DOI： 10.16016/j.1000-5404.201711131.
Hong LIU, Yuanjing JIANG, Shuixia LIU. Efficacy of standardized cancer pain treatment for improving quality of life in patients with severe cancer pain[J]. Journal of Third Military Medical University, 2018, 40(10): 934-938. DOI： 10.16016/j.1000-5404.201711131.
摘要
目的
2
探讨癌痛规范化治疗对中重度癌痛患者生活质量及临床效果的影响分析。
方法
2
采用患者自身前后对照、前瞻性研究方法，以2016年1月至2017年6月陆军军医大学第三附属医院(野战外科研究所)肿瘤中心收治的晚期癌症并伴有中重度癌痛的110例患者为研究对象，实施以疼痛的“常规、量化、全面、动态”评估、规范化综合治疗、不良反应防治、健康教育和随访为护理要点的癌痛规范化治疗，以数字疼痛分级法(numerical rating scale
NRS)、生活质量评分(quality of life
QOL)和体能状况Karn of sky评分法(KPS)、不良反应发生率作为评价指标，比较分析患者实施癌痛规范化治疗前后生活质量的变化。
结果
2
中重度癌痛患者在实施规范化治疗后，92.7%患者的疼痛强度降低至轻度疼痛或无痛；不良反应(便秘、头晕、恶心呕吐、嗜睡和尿潴留)发生率明显降低(
P
<
0.05)；生活质量评分的12项内容均明显改善，平均QOL评分和KPS评分分别为49.91±7.64和84.51±3.56，显著高于规范化治疗前的29.40±10.38和68.42±9.23，差异有统计学意义(
P
<
0.05)。
结论
2
实施癌痛规范化治疗能有效缓解晚期癌症患者的疼痛，降低药物的不良反应发生率，改善体能状态，提高生活质量。
Abstract
Objective
2
To evaluate the effect of standardized cancer pain treatment for improving the quality of life (QOL) in the patients with severe cancer pain.
Methods
2
This prospective
self-controlled study was conducted among 110 terminal cancer patients with severe pain hospitalized in our center between January
2016 and June
2017. The patients received standardized pain management with routine
quantitative
comprehensive and dynamic pain assessment
standardized comprehensive treatment
adverse effect control
health education and follow-up. The changes in the patients' QOL after the implementation of standardized treatment were assessed in terms of changes in numerical rating scale (NRS) scores
QOL scores
Karn of sky performance status (KPS) and the incidence of adverse reactions.
Results
2
After the implementation of the standardized pain management
92.7% of the patients with moderate or severe cancer pain reported obviously reduced pain intensity to mild pain or total pain relief with also significantly reduced
incidences of adverse reactions (constipation
dizziness
nausea
vomiting
drowsiness and urinary retention) (
P
<
0.05). The standardized pain management achieved significant improvements in the scores of the 12 quality of life items
and significantly reduced the average QOL score (from 49.91±7.64 to 29.40±10.38) and KPS score (from 84.51±3.56 to 68.42±9.23) of the patients (
P
<
0.05).
Conclusion
2
The standardized cancer pain treatment can effectively reduce the pain level
reduce the incidence of adverse reactions
and improve the physical condition and quality of life of patients with terminal cancer.
关键词
Keywords
references
中华人民共和国卫生部.癌症疼痛诊疗规范(2011年版)[J].临床肿瘤学杂志, 2012, 17(2): 153-158. DOI: 10.3969/j.issn.1009-0460.2012.02.014.
Ministry of Health of the PRC. Standard for diagnosis and treatment of cancer pain (Version 2011)[J]. Chin Clin Oncol, 2012, 17(2): 153-158. DOI: 10.3969/j.issn.1009-0460.2012.02.014.
MCCAFFERY M. Paincontrol. Barriers to the use of available information. World Health Organization Expert Committee oncancerpainreliefand active supportive care[J]. Cancer, 1992, 70(5 Suppl): 1438-1449.
蔡惠芳, 沈琴.基层医院建立癌痛规范化治疗示范病房的体会[J].护理与康复, 2013, 12(6): 584-586. DOI: 10.3969/j.issn.1671-9875.2013.06.036.
CAI H F, SHEN Q. Experience of establishing standardized treatment ward for cancer pain in primary hospital[J]. Nurs Rehabil J, 2013, 12(6): 584-586. DOI: 10.3969/j.issn.1671-9875.2013.06.036.
王楠娅, 刘玉梅, 赵恒军, 等.影响慢性中重度癌痛患者疼痛治疗效果的相关因素分析[J].中国肿瘤临床, 2014, 41(10): 655-658. DOI:10.3969/j.issn.1000-8179.20132077.
WANG N Y, LIU Y M, ZHAO H J, et al . Factors influencing the treatment effect of cancer pain in patients with moderate and severe chronic pain[J ] . Chin J Clin Oncol, 2014, 41 (10): 655-658. DOI: 10.3969/j.issn.1000-8179.20132077.
谭诚炜.三阶梯镇痛简介及其应用现况[J].上海医药, 2015, 36(2): 46-48.
TAN C W. Brief introduction of three steps analgesia and its application[J]. Shanghai Med, 2015, 36(2): 46-48.
李红.电话随访式疼痛管理对癌痛患者镇痛药物治疗依从性的影响[J].护理实践与研究, 2016, 13(8): 135-136. DOI: 10.3969/j.issn.1672-9676.2016.08.063.
LI H. Effect of telephone follow-up pain management on analgesic compliance in patients with cancer pain[J]. Nurs Practice Res, 2016, 13(8): 135-136. DOI: 10.3969/j.issn.1672-9676.2016.08.063.
NAING C, AUNG K, RACLOZ V, et al . Safety and efficacy of transdermal buprenorphine for thereliefofcancerpain[J ] . J Cancer Res Clin Oncol, 2013, 139(12): 1963-1970.DOI: 10.1007/s00432-013-1487-0.
李霞, 秦怡菲.癌痛规范化治疗在晚期癌症病人镇痛中的应用[J].护理研究, 2014, 28(5): 1719-1720. DOI: 10.3969/j.issn.1009-6493.2014.14.022.
LI X, QIN Y F. Application of standardized treatment of cancer pain in analgesia for advanced cancer patients[J]. Chin Nurs Res, 2014, 28(5): 1719-1720. DOI: 10.3969/j.issn.1009-6493.2014.14.022.
张宇, 高灵, 李晓良, 等.癌痛规范化治疗对民族地区晚期癌症患者疼痛的影响[J].青海医药杂志, 2016, 46(6): 1-5.
ZHANG Y, GAO L, LI X L, et al . Effect of standardized treatment of cancer pain on pain of patients with advanced cancer in ethnic minority areas[J ] . Qinghai Med J, 2016, 46(6): 1-5.
武林鑫, 孙莉.癌痛治疗不足的现状与原因[J].肿瘤防治研究, 2014, 41(4): 421-424. DOI: 10.3971/j.issn.1000-8578.2014.04.031.
WU L X, SUN L. Status and relevant causes of cancer pain undertreatment[J]. Cancer Res Prev Treat, 2014, 41(4): 421-424. DOI: 10.3971/j.issn.1000-8578.2014.04.031.
U. S. Food and Drug Administration. Extended-release (ER) and long-acting (LA) opioid analgesics risk evaluation and mitigation strategy (REMS)[M]. MD: Silver Spring, 2013.
SHEINFELD GORIN S, KREBS P, BADR H, et al . Meta-analysis of psychosocial interventions to reduce pain in patients with cancer[J ] . J Clin Oncol, 2012, 30(5): 539-547.DOI: 10.1200/JCO.2011.37.0437.
罗帼英.癌痛患者止痛治疗依从性影响因素分析及护理[J].护理学报, 2010, 17(5B): 29-30. DOI: 10.3969/j.issn.1008-9969.2010.10.011.
LUO G Y. Analysis of influencing factors of pain relief compliance in cancer patients and nursing care[J]. J Nurs, 2010, 17(5B): 29-30. DOI: 10.3969/j.issn.1008-9969.2010.10.011.
童莺歌, 叶志弘.浙江省4家三级医院护士疼痛管理知识和态度的调查与分析[J].护理与康复, 2010, 9(9): 747-749, 752. DOI: 10.3969/j.issn.1671-9875.2010.09.004.
TONG Y G, Y E Z H. Survey and analysis on knowledge and attitude of pain management for nurses from 4 top hospitals in Zhejiang Province[J]. Nurs Rehabil J, 2010, 9(9): 747-749, 752. DOI: 10.3969/j.issn.1671-9875.2010.09.004.
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