目的 调查中重度癌痛的分布特点及阿片类药物的使用现状,为中重度癌痛的治疗提供参考.方法 回顾性分析146例中重度癌痛患者临床资料,分析阿片类药物日使用剂量及癌痛发生率与年龄、性别、身高、体质量、体表面积及肿瘤类型等因素的关系.结果 使用阿片类药物的患者中,不同性别的癌痛发生率及日平均口服剂量差异均无统计学意义(x2=0.473,Z=-0.185,P均＞0.05);不同年龄组的癌痛发生率比较差异无统计学意义(Z =2.280,P=0.684),将各年龄组日平均剂量进行比较,＞ 80岁组日平均剂量明显低于其他各组(Z值分别为-2.745、-1.986、-2.141、-2.162,P均＜0.05);不同类别的肿瘤患者中肝、胆、胰腺肿瘤患者的癌痛发生率最高,为67.50％ (27/40),其次为转移性肿瘤62.50％(10/16),泌尿性肿瘤61.54％ (8/13),肺癌52.63％(50/95),乳腺癌及妇科肿瘤50.00％(17/34),胃肠道肿瘤41.94％(26/62),其他肿瘤38.46％(5/13),头颈部肿瘤的癌痛发生率最低(25.00％,3/12),其差异有统计学意义(x2=23.672,P＜0.05);不同类型的肿瘤患者依据日平均口服吗啡量的大小从高到低排列依次为转移性肿瘤160(80,200) mg,乳腺癌及妇科肿瘤120(60,160) mg,肺癌100(40,125) mg,泌尿系肿瘤90(45,115) mg,其他肿瘤80(60,160) mg,肝、胆、胰腺肿瘤70(50,90)mg,胃肠道肿瘤60(40,80) mg,头颈部肿瘤55(40,70) mg.各组之间比较其剂量差异有统计学意义(H=14.280,P＜0.05).癌痛患者身高、体质量、体表面积与日平均吗啡用量间无明显相关性(r值分别为-0.045、-0.042、-0.046,P均＜0.05).结论 不同性别及不同年龄的肿瘤患者出现中重度癌痛的比率差异无统计学意义,但癌痛发生率在不同肿瘤类型间有统计学意义.癌痛患者的日平均吗啡量与性别、身高、体质量及体表面积无关,年龄＞80岁的癌痛患者其日平均吗啡量明显低于其他年龄组.癌痛患者日平均吗啡量与肿瘤类型密切相关.
目的 調查中重度癌痛的分佈特點及阿片類藥物的使用現狀,為中重度癌痛的治療提供參攷.方法 迴顧性分析146例中重度癌痛患者臨床資料,分析阿片類藥物日使用劑量及癌痛髮生率與年齡、性彆、身高、體質量、體錶麵積及腫瘤類型等因素的關繫.結果 使用阿片類藥物的患者中,不同性彆的癌痛髮生率及日平均口服劑量差異均無統計學意義(x2=0.473,Z=-0.185,P均＞0.05);不同年齡組的癌痛髮生率比較差異無統計學意義(Z =2.280,P=0.684),將各年齡組日平均劑量進行比較,＞ 80歲組日平均劑量明顯低于其他各組(Z值分彆為-2.745、-1.986、-2.141、-2.162,P均＜0.05);不同類彆的腫瘤患者中肝、膽、胰腺腫瘤患者的癌痛髮生率最高,為67.50％ (27/40),其次為轉移性腫瘤62.50％(10/16),泌尿性腫瘤61.54％ (8/13),肺癌52.63％(50/95),乳腺癌及婦科腫瘤50.00％(17/34),胃腸道腫瘤41.94％(26/62),其他腫瘤38.46％(5/13),頭頸部腫瘤的癌痛髮生率最低(25.00％,3/12),其差異有統計學意義(x2=23.672,P＜0.05);不同類型的腫瘤患者依據日平均口服嗎啡量的大小從高到低排列依次為轉移性腫瘤160(80,200) mg,乳腺癌及婦科腫瘤120(60,160) mg,肺癌100(40,125) mg,泌尿繫腫瘤90(45,115) mg,其他腫瘤80(60,160) mg,肝、膽、胰腺腫瘤70(50,90)mg,胃腸道腫瘤60(40,80) mg,頭頸部腫瘤55(40,70) mg.各組之間比較其劑量差異有統計學意義(H=14.280,P＜0.05).癌痛患者身高、體質量、體錶麵積與日平均嗎啡用量間無明顯相關性(r值分彆為-0.045、-0.042、-0.046,P均＜0.05).結論 不同性彆及不同年齡的腫瘤患者齣現中重度癌痛的比率差異無統計學意義,但癌痛髮生率在不同腫瘤類型間有統計學意義.癌痛患者的日平均嗎啡量與性彆、身高、體質量及體錶麵積無關,年齡＞80歲的癌痛患者其日平均嗎啡量明顯低于其他年齡組.癌痛患者日平均嗎啡量與腫瘤類型密切相關.
목적 조사중중도암통적분포특점급아편류약물적사용현상,위중중도암통적치료제공삼고.방법 회고성분석146례중중도암통환자림상자료,분석아편류약물일사용제량급암통발생솔여년령、성별、신고、체질량、체표면적급종류류형등인소적관계.결과 사용아편류약물적환자중,불동성별적암통발생솔급일평균구복제량차이균무통계학의의(x2=0.473,Z=-0.185,P균＞0.05);불동년령조적암통발생솔비교차이무통계학의의(Z =2.280,P=0.684),장각년령조일평균제량진행비교,＞ 80세조일평균제량명현저우기타각조(Z치분별위-2.745、-1.986、-2.141、-2.162,P균＜0.05);불동유별적종류환자중간、담、이선종류환자적암통발생솔최고,위67.50％ (27/40),기차위전이성종류62.50％(10/16),비뇨성종류61.54％ (8/13),폐암52.63％(50/95),유선암급부과종류50.00％(17/34),위장도종류41.94％(26/62),기타종류38.46％(5/13),두경부종류적암통발생솔최저(25.00％,3/12),기차이유통계학의의(x2=23.672,P＜0.05);불동류형적종류환자의거일평균구복마배량적대소종고도저배렬의차위전이성종류160(80,200) mg,유선암급부과종류120(60,160) mg,폐암100(40,125) mg,비뇨계종류90(45,115) mg,기타종류80(60,160) mg,간、담、이선종류70(50,90)mg,위장도종류60(40,80) mg,두경부종류55(40,70) mg.각조지간비교기제량차이유통계학의의(H=14.280,P＜0.05).암통환자신고、체질량、체표면적여일평균마배용량간무명현상관성(r치분별위-0.045、-0.042、-0.046,P균＜0.05).결론 불동성별급불동년령적종류환자출현중중도암통적비솔차이무통계학의의,단암통발생솔재불동종류류형간유통계학의의.암통환자적일평균마배량여성별、신고、체질량급체표면적무관,년령＞80세적암통환자기일평균마배량명현저우기타년령조.암통환자일평균마배량여종류류형밀절상관.
Objective To investigate the distribution of moderate to severe cancer pain and administrated dose of opioid drugs in order to provide the reference for the treatment of moderate and severe cancer pain.Methods Retrospective analyzed the clinical data of 146 patients with moderate to severe cancer pain.The information were recorded including opioid use dose,cancer pain incidence,age,gender,height,weight,body surface area and type of tumor.Results There were no significant difference among patients with opioids drug administration in terms of gender,average daily oral dose(x2 =0.473,Z =-0.185,P ＞ 0.05).Meanwhile cancer incidence rate was same in different age groups (x2 =2.280,P =0.684).The average daily opioid dose in patients with over 80 year old was the lowest among other age groups (Z =-2.745,-1.986,-2.141,-2.162;P ＜0.05).Cancer pain incidence in patients with hepatobiliary pancreatic tumors were 67.50％ (27/40),highest than other different types cancer including metastatic tumor(62.50％ (10/16)),urinary tumor (61.54％ (8/13)),lung cancer (52.63％ (50/95)),breast cancer and gynecological tumor (50.00％ (17/34)),gastrointestinal tumor(41.94％ (26/62)),other tumors 38.46％ (5/13) and head and neck tumor(25.00％ (3/12)),the difference was statistically significant (x2 =23.672,P ＜ 0.05).The average day oral morphine dose of different types tumor were listed as followed from high to low in the order:160 (80,200) mg of metastatic tumors,120 (60,160) mg of breast and gynecological tumor,100 (40,125) mg of lung cancer,90(45,115) mg of urinary tract tumors,80(60,160) mg of other tumors,70(50,90) mg of hepatobiliary pancreatic tumor,60 (40,80) mg of gastrointestinal tumor,55 (40,70) mg of head and neck tumor.There were significant differences in terms of among oral morphine dose per day of different type tumors (H=14.280,P ＜0.05).No correlation was found between pain patients with height,body mass,body surface area and average daily dose of morphine (r =-0.045,-0.042,-0.046 ; P ＜ 0.05).Conclusion No significant differences were found in terms of moderate to severe cancer pain among different type tumors at different and age groups.While there is significant difference in term of cancer pain incidence among different tumor types.The average daily amount of morphine in patients with cancer pain is not related to gender,height,body mass and body surface area.The average amount of morphine of patients with age over 80 years old is significantly lower than that of the other age groups,and the average amount of morphine t is related to cancer type.
