Medical Oncology Department, Pediatric Oncology Center,Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China.
Department of Pharmacy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Medicine (Baltimore). 2022 Dec 9;101(49):e31422. doi: 10.1097/MD.0000000000031422.
Systematic pain management of children is insufficient in China, and there is no literature on pain in children with sarcoma.
Clinical data of 188 patients with newly diagnosed sarcoma admitted to the Medical Oncology Department of Beijing Children's Hospital was collected from October 2018 to December 2020. Children experiencing pain received analgesic treatment and regular assessment.
Thirty-seven patients (19.7%) suffered from pain. Six cases (16.2%) had mild pain, 17 (46.0%) moderate, and 14 (37.8%) severe. Daily lives of 31 patients were affected by pain. Twenty-six cases had bone invasion. The analgesic rate was 54.1% before admission and 89.2% after admission. Nine cases were treated with oral morphine regularly, and their pain was relieved before chemotherapy; the dose of morphine was 0.14 ± 0.034 mg/kgQ4H when the target was reached. No serious adverse reactions were observed. The period of morphine application after chemotherapy was 5 to 9 days, and there was no withdrawal reaction.
Pain in children with newly diagnosed sarcoma was mainly moderate to severe, and the incidence of pain in sarcoma with bone invasion was higher, with greater intensity. Patients who received standardized pain assessment and regular analgesics reached pain relief quickly, and no serious adverse reactions were observed within the recommended dosage.
中国儿童的系统性疼痛管理不足,且骨肉瘤患儿的疼痛问题暂无相关文献报道。
收集 2018 年 10 月至 2020 年 12 月期间于北京儿童医院肿瘤内科新诊断为肉瘤的 188 例患儿的临床资料。对有疼痛的患儿给予镇痛治疗和定期评估。
37 例(19.7%)患儿存在疼痛,其中轻度疼痛 6 例(16.2%),中度疼痛 17 例(46.0%),重度疼痛 14 例(37.8%)。31 例患儿日常生活受到疼痛影响。26 例有骨侵犯。入院前镇痛有效率为 54.1%,入院后为 89.2%。9 例行口服吗啡规律镇痛治疗,化疗前疼痛缓解,吗啡剂量为 0.14 ± 0.034 mg/kgQ4H 时达到目标。未观察到严重不良反应。化疗后应用吗啡的时间为 5~9 天,未出现撤药反应。
新诊断骨肉瘤患儿的疼痛主要为中重度,骨侵犯患儿疼痛发生率较高,疼痛程度更剧烈。接受规范化疼痛评估和规律镇痛药物治疗的患儿疼痛缓解迅速,在推荐剂量内未观察到严重不良反应。