Cancer Center, The First Hospital of Jilin University, Changchun, China.
Cancer Center, The First Hospital of Jilin University, Changchun, China.
Curr Probl Cancer. 2019 Feb;43(1):77-85. doi: 10.1016/j.currproblcancer.2018.05.002. Epub 2018 May 24.
To analyze clinical factors that were associated with inadequate pain control in cancer patients with metastatic malignancy and moderate to severe baseline pain.
We retrospectively analyzed data from 260 advanced cancer patients who admitted to the First Hospital of Jilin University (Jilin, China) from January 2012-May 2013.
Statistical analysis was performed to assess the correlation between pain control and baseline characteristics including, gender, patient age, type of malignancy, presence of bone metastases, pain intensity, pain location, etiology of pain, type of pain, and presence of breakthrough pain.
A total of 75.4% of patients obtained satisfactory pain control (numerical rating scale ≤ 3) in 3 days. Baseline characteristics including gastrointestinal tumors (P = 0.032), severe pain (P < 0.001), and frequent breakthrough pain (P < 0.001) were independent risk factors of poor pain control in the 3-day treatment. These factors were also significantly associated with longer time needed to achieve stable pain control. Of the 185 patients treated with opioids, higher doses of analgesics were used in younger patients (<60 years old; P = 0.018), and in patients with severe pain (P < 0.001), neuropathic pain (P = 0.002), and frequent breakthrough pain (P = 0.015).
Factors associated with more difficult pain control include gastrointestinal tumor, severe baseline pain, presence of breakthrough pain, and neuropathic etiology of pain.
分析与中重度基线疼痛的转移性恶性肿瘤癌症患者疼痛控制不足相关的临床因素。
我们回顾性分析了 2012 年 1 月至 2013 年 5 月期间入住吉林大学第一医院的 260 例晚期癌症患者的数据。
进行统计分析以评估疼痛控制与基线特征之间的相关性，包括性别、患者年龄、恶性肿瘤类型、骨转移存在、疼痛强度、疼痛位置、疼痛病因、疼痛类型和爆发性疼痛存在。
共有 75.4%的患者在 3 天内获得了满意的疼痛控制（数字评分量表≤3）。基线特征包括胃肠道肿瘤（P = 0.032）、重度疼痛（P < 0.001）和频繁爆发性疼痛（P < 0.001）是 3 天治疗中疼痛控制不佳的独立危险因素。这些因素也与达到稳定疼痛控制所需的时间较长显著相关。在接受阿片类药物治疗的 185 例患者中，年轻患者（<60 岁；P = 0.018）和重度疼痛（P < 0.001）、神经病理性疼痛（P = 0.002）和频繁爆发性疼痛（P = 0.015）的患者使用了更高剂量的镇痛药。
与更难控制的疼痛相关的因素包括胃肠道肿瘤、重度基线疼痛、爆发性疼痛的存在和神经病理性疼痛病因。
