论文部分内容阅读
１９９２年我们对我国癌症病人疼痛和生活质量组织了三省市１１单位的前瞻性调查。在１５４３例各类癌症患者中，有７８９例（５１．１％）伴有不同程度的疼痛。早、中、晚期患者伴有疼痛分别占３０％，５０．６％和６６．４％。在所有伴有疼痛的患者中直接由肿瘤本身引起的占７８．６％，其它原因仅占２０％左右，其中伴有两种以上原因的为６．７％。对癌症类型、疼痛性质和部位也作了分析。在３８６例有远处转移的病人中伴有疼痛的为８５％。在各种镇痛方法中，抗肿瘤治疗的例数最多（６１％），其次为镇痛药物（３７％）和中药治疗（２３．４％），针刺和神经阻滞各占１．８％和０．４％。在７８９例有疼痛的病人中，有１９３例（２４．５％）未得到相应治疗，其中近８０％为轻度疼痛，２０％为中度疼痛，仅１例为重度疼痛。按ＷＨＯ三阶梯治疗的１４１例有效率为８７．２％，而且重度疼痛者较多。对生活质量指标的调查，早期病人的平均记分为５０．６±５．９，中期病人为４７．１±７．２，晚期病人为４２．９±８．９。晚期病人的生活质量（ＱＯＬ）较早期病人要差，说明ＱＯＬ与肿瘤的进展有明确的相关关系。
In 1992, we conducted a prospective survey of 11 units in three provinces and cities for the pain and quality of life of cancer patients in our country. Of the 1543 cancer patients, 789 (51.1%) were associated with varying degrees of pain. Patients with early, middle, and late comorbid pain accounted for 30%, 50.6%, and 66.4%, respectively. Of all patients with pain, 78.6% were directly caused by the tumor itself, and other reasons accounted for only about 20%, of which 6.7% were associated with more than two causes. The type of cancer, the nature of the pain, and the site were also analyzed. Of the 386 patients with distant metastases, 85% were associated with pain. In all kinds of analgesic methods, the number of anti-tumor treatments was the highest (61%), followed by analgesic drugs (37%) and traditional Chinese medicine (23.4%), and acupuncture and nerve block each accounted for 1.8. % and 0.4%. Of the 789 patients with pain, 193 (24.5%) did not receive appropriate treatment. Nearly 80% had mild pain, 20% had moderate pain, and only 1 had severe pain. According to the WHO three-step treatment, the effective rate of 141 cases was 87.2%, and there were more severe pain patients. For the investigation of quality of life indicators, the average score of early patients was 50.6±5.9, that of intermediate patients was 47.1±7.2, and that of late patients was 42.9±8.9. The quality of life (QOL) of late-stage patients was worse than that of early-stage patients, indicating a clear correlation between QOL and tumor progression.