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目的:本研究旨在通过对神经病理性癌痛(NCP)的发病率和诊疗现状的调查,以寻求更好地控制NCP。方法:运用描述性研究方法,对658例癌痛患者临床特点进行横断面调查,对治疗进行前瞻性随访。NCP诊断标准依照NeuPSIG神经病理性疼痛的最新定义和ID-Pain量表。治疗方案依据NCCN成人癌痛治疗指南,包括镇痛辅助药物、姑息性放化疗和手术,研究周期为3周。结果:符合NP诊断者147例,纳入ITT统计118例。侵犯神经常见于腰骶丛、颈丛、臂丛。临床症状以麻木感、针刺痛和烧灼痛多见。疼痛NRS基础评分5.0±1.4,第3天降至3.7±1.5(P<0.001)。感觉超敏第3天改善(P=0.020)。烧灼痛、电击痛第7天改善(P=0.003,0.018)。生活质量第3天改善(P=0.002)。结论:NCP发病率为22.3%。采用阿片药物为主的综合治疗,多数神经病理性癌痛明显减轻。针刺样痛和麻木感较烧灼痛、电击痛和感觉过敏更加难以控制。
Purpose: This study sought to better control NCP by investigating the incidence and diagnosis and treatment of neuropathic cancer pain (NCP). Methods: By means of descriptive method, the clinical features of 658 cases of cancer patients were investigated by cross-sectional investigation and the patients were followed up prospectively. The NCP diagnostic criteria were based on the latest definition of NeuPSIG neuropathic pain and the ID-Pain scale. The treatment regimen is based on the NCCN Guidelines for the Treatment of Adult Cancer Pain, including adjuvant analgesics, palliative radiotherapy and surgery, with a study period of 3 weeks. Results: In line with the NP diagnosis of 147 cases, including ITT statistics 118 cases. Invasion of nerve common in the lumbosacral plexus, cervical plexus, brachial plexus. Clinical symptoms numbness, acupuncture and burning pain more common. The NRS basal score for pain was 5.0 ± 1.4 and dropped to 3.7 ± 1.5 on day 3 (P <0.001). Sensory hypersensitivity improved on the third day (P = 0.020). Burning pain, electric shock improved on the 7th day (P = 0.003,0.018). Quality of life improved on the third day (P = 0.002). Conclusion: The incidence of NCP is 22.3%. The use of opioid-based comprehensive treatment, the majority of neuropathic pain relief significantly reduced. Acupuncture-like pain and numbness than burning pain, electric shock pain and hypersensitivity more difficult to control.