恶性肿瘤骨转移疼痛患者治疗及预后的临床分析

发布时间：2018-05-22 10:24

本文选题：骨转移 + 疼痛　；参考：《中国医科大学学报》2015年05期

【摘要】：目的分析骨转移患者骨痛发病特点、内科治疗效果及预后,并对镇痛药物用药合理性进行分析,以提高临床对骨转移疼痛的诊治水平。方法对123例伴有疼痛的恶性肿瘤骨转移患者进行规范三阶梯止痛治疗及抗肿瘤治疗,并对其临床特征进行回顾性分析。结果总疼痛缓解率85.4%,疼痛程度明显减轻(P0.05)。各麻醉类药物DUI值均接近1,用药趋向合理。Kaplan-Meier生存分析显示,中度疼痛者生存明显优于重度疼痛者(P=0.015);疼痛明显缓解者生存明显优于未明显缓解者(P=0.021);无内脏转移者生存优于伴有内脏转移者(P=0.000)。COX多因素分析结果显示,疼痛程度、是否内脏转移是影响预后的独立危险因素。结论规范治疗可使多数骨转移疼痛患者症状改善,并在一定程度上延长生存时间。阿片类药物对中重度疼痛具有理想的止痛效果,不良反应可以耐受。
[Abstract]:Objective to analyze the characteristics of bone pain in patients with bone metastasis, the effect of medical treatment and the prognosis, and to analyze the rationality of analgesic drugs in order to improve the clinical diagnosis and treatment of bone metastasis pain. Methods 123 patients with bone metastasis of malignant tumor with pain were treated with standard triple step analgesic therapy and antitumor therapy. The clinical features were analyzed retrospectively. Results the total pain relief rate was 85.4%, and the pain degree was significantly alleviated (P 0.05). The DUI values of all anesthetic drugs were close to 1. Kaplan-Meier survival analysis showed that the drug was more reasonable. The survival of patients with moderate pain was significantly better than that of patients with severe pain, the survival of patients with obvious pain relief was significantly better than that of patients with no obvious remission of pain, and the survival of patients without visceral metastasis was better than that of patients with visceral metastasis. Cox multivariate analysis showed that the degree of pain was higher than that of patients with visceral metastasis. Visceral metastasis is an independent risk factor for prognosis. Conclusion the standard treatment can improve the symptoms of most patients with bone metastases and prolong the survival time to some extent. Opioids have an ideal analgesic effect on moderate and severe pain, and adverse reactions can be tolerated.
【作者单位】：中国医科大学附属第一医院肿瘤内科;
【分类号】：R738.1

【参考文献】