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日本乳腺专科医生对乳房切除术后疼痛综合征的认知调查及治疗现状

Survey on recognition of post-mastectomy pain syndrome by breast specialist physician and present status of treatment in Japan.

作者信息

Kojima Keiko Y, Kitahara Masaki, Matoba Motohiro, Shimoyama Naohito, Uezono Shoichi

机构信息

Department of Anesthesiology, The Jikei University Hospital, 3-19-18 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8471, Japan,

出版信息

Breast Cancer. 2014 Mar;21(2):191-7. doi: 10.1007/s12282-012-0376-8. Epub 2012 May 30.

Abstract

BACKGROUND

Post-mastectomy pain syndrome (PMPS) is chronic pain after breast cancer surgery and is reported to influence quality of life (QOL). Although the results of a survey in Japan showed high incidence, at 21-65 %, many of the patients had never been treated for PMPS. One reason for this low treatment rate may be poor understanding of PMPS by medical personnel. In this study, we conducted the survey by using questionnaire to assess current treatment and the recognitions of the medical personnel.

METHODS

We mailed a questionnaire to 647 specialist members of the Breast Cancer Society.

RESULTS

Of those, 34.7 % responsed. While PMPS was recognized by as much as 70.5 % of responding physicians, it was treated by as little as 47.7 % of the responders. In addition, while non-steroidal anti-inflammatory drugs (NSAIDs), which were ineffective in relieving PMPS, were used by 78.4 % of the responders, effective drugs were rarely used; therefore, treatment was considered ineffective by 69.5 %. This indicates that appropriate therapies are not widely used, and none of the current therapies are very effective.

CONCLUSIONS

The results showed high recognition of PMPS pathology among physicians, but the treatment rate was as low as 47.7 %. NSAIDs were the main treatment, and the treatment effects were not satisfactory. It was revealed that currently appropriate treatment modalities have not been widely used. Education of physicians, distribution of treatment information and further studies are considered necessary for the spread of appropriate treatment modality.

摘要

背景

乳房切除术后疼痛综合征(PMPS)是乳腺癌手术后的慢性疼痛,据报道会影响生活质量(QOL)。尽管日本的一项调查结果显示发病率很高,为21%-65%,但许多患者从未接受过PMPS治疗。治疗率低的一个原因可能是医务人员对PMPS的了解不足。在本研究中,我们通过问卷调查来评估当前的治疗情况以及医务人员的认知。

方法

我们向乳腺癌协会的647名专家成员邮寄了问卷。

结果

其中34.7%进行了回复。虽然70.5%的回复医生认识到了PMPS,但只有47.7%的回复者对其进行了治疗。此外,78.4%的回复者使用了对缓解PMPS无效的非甾体抗炎药(NSAIDs),而有效药物很少使用;因此,69.5%的人认为治疗无效。这表明适当的治疗方法没有得到广泛应用,而且目前的治疗方法都不是非常有效。

结论

结果显示医生对PMPS病理的认知度很高,但治疗率低至47.7%。NSAIDs是主要治疗方法,治疗效果并不令人满意。结果表明目前适当的治疗方式尚未得到广泛应用。为了推广适当的治疗方式,对医生进行教育、分发治疗信息以及进一步开展研究被认为是必要的。

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