CAJ | 학술논문

目的：分析影响慢性中重度癌痛患者疼痛治疗效果的相关因素，进一步指导临床治疗。方法：收集426例确诊为恶性肿瘤且伴有慢性中重度癌痛患者的相关资料，分析影响疼痛治疗效果的相关因素。结果：患者3 d内疼痛控制良好率为85.6%。合并骨转移（P=0.026）、疼痛控制后仍有爆发痛发生（P<0.001）、每日等效口服吗啡剂量（morphine equivalent daily dose，MEDD）较大（P<0.001）的患者疼痛控制不佳；而阿片类药物联合非甾体抗炎药（nonsteroidal anti-inflammatory drugs，NSAIDs）有利于疼痛的控制（P=0.024）。单因素分析显示消化系统肿瘤、疼痛强度、四肢痛、合并神经病理性疼痛、应用芬太尼透皮贴剂、Ⅳ期患者中多部位转移为疼痛控制的危险因素（P<0.05）。结论：合并骨转移、存在爆发痛、MEDD较大为疼痛的独立危险因素。联合作用NA-SIDs为疼痛控制的保护因素。
목적：분석영향만성중중도암통환자동통치료효과적상관인소，진일보지도림상치료。방법：수집426례학진위악성종류차반유만성중중도암통환자적상관자료，분석영향동통치료효과적상관인소。결과：환자3 d내동통공제량호솔위85.6%。합병골전이（P=0.026）、동통공제후잉유폭발통발생（P<0.001）、매일등효구복마배제량（morphine equivalent daily dose，MEDD）교대（P<0.001）적환자동통공제불가；이아편류약물연합비치체항염약（nonsteroidal anti-inflammatory drugs，NSAIDs）유리우동통적공제（P=0.024）。단인소분석현시소화계통종류、동통강도、사지통、합병신경병이성동통、응용분태니투피첩제、Ⅳ기환자중다부위전이위동통공제적위험인소（P<0.05）。결론：합병골전이、존재폭발통、MEDD교대위동통적독립위험인소。연합작용NA-SIDs위동통공제적보호인소。
Objective:This study aimed to analyze the factors affecting the outcome of cancer pain in patients with moderate and severe chronic cancer pain for clinical decision making. Methods: Data were collected from 426 cancer patients with moderate and severe chronic cancer pain, and the factors affecting pain treatment were analyzed. Results:A total of 85.6%of patients had good pain control in 3 days (NRS≤3). Multivariate logistic regression models showed that the pain of patients with bone metastases (P=0.026), breakthrough pain after stable pain control (P<0.001), and high MEDD (P<0.001) was poorly controlled. Moreover, age, sex, TNM stage, cause of pain, and medication ladder were not risk factors of pain control (P>0.05). Opioid combination with NSAIDs contributed to easier pain control (P=0.024). Digestive system tumors, pain intensity, limb pain, neuropathic pain, use of transdermal fentanyl matrix patch, multiple metastases in stage-IV patients were suggested to be risk factors of pain control in univariate logistic regression models (P<0.05). Conclusion: Bone metastases, breakthrough pain after pain relief, and high dose of MEDD were independent risk factors. Opioid combination with NSAIDs was a protective factor of pain control.