CAJ | 학술논문

目的：调查癌痛患者经规范化止痛治疗前后心理痛苦状况及影响因素，探讨规范化止痛治疗对心理痛苦的影响。方法引用美国国立综合癌症网（NCCN）推荐的心理痛苦温度计（DT）、数字疼痛程度评估量表（NRS），对122例NRS评分≥4分的中重度疼痛、拟接受阿片类药物止痛治疗的癌痛患者分别在规范化止痛治疗前及达理想止痛治疗后进行调查。结果114例患者止痛治疗后达止痛目标，止痛有效率为93．44％；止痛治疗前DT平均得分（5．23±1．43），止痛治疗后DT平均得分（2．37±1．37），差异有统计学意义（t＝15．952，P＜0．01）；止痛治疗前后癌痛患者在疼痛、活动受限、食欲差、便秘、患者管理家庭的能力、担忧疾病进展、睡眠障碍方面比较差异均有统计学意义（P＜0．01）；中重度疼痛患者心理痛苦率为100％，是心理痛苦影响因素的首位；第2位为睡眠障碍，患者的心理痛苦率为90．17％。结论规范止痛可以减轻癌痛患者的心理痛苦，值得临床推广应用。
목적：조사암통환자경규범화지통치료전후심리통고상황급영향인소，탐토규범화지통치료대심리통고적영향。방법인용미국국립종합암증망（NCCN）추천적심리통고온도계（DT）、수자동통정도평고량표（NRS），대122례NRS평분≥4분적중중도동통、의접수아편류약물지통치료적암통환자분별재규범화지통치료전급체이상지통치료후진행조사。결과114례환자지통치료후체지통목표，지통유효솔위93．44％；지통치료전DT평균득분（5．23±1．43），지통치료후DT평균득분（2．37±1．37），차이유통계학의의（t＝15．952，P＜0．01）；지통치료전후암통환자재동통、활동수한、식욕차、편비、환자관리가정적능력、담우질병진전、수면장애방면비교차이균유통계학의의（P＜0．01）；중중도동통환자심리통고솔위100％，시심리통고영향인소적수위；제2위위수면장애，환자적심리통고솔위90．17％。결론규범지통가이감경암통환자적심리통고，치득림상추엄응용。
Objective To survey the psychological pain condition in patients and influencing factors before and after standardized acesodyne treatment , analyze the relationship between the two factors , and discuss the effect of the standardized acesodyne treatment on psychological pain in patients with cancer pain . Methods Thepsychological Distress Thermometer (DT) and Numeric Rating Scale (NRS) recommended by National Comprehensive Cancer Network ( NCCN) were used to investigate respectively 122 patients with moderate severe pain that the score of NRS was more than 4 and the patients would accept opioid analgesic treatment before and after ideal acesodyne treatment .Results One hundred and fourteen patients reached acesodyne goal after treatment, and the effective rate of acesodyne was 93.44%;the average score of DT before treatment was (5.23 ±1.43), and was (2.37 ±1.37) after treatment, and the difference was statistically significant (t=15.952, P <0.01).The significant differences were found in the effects of pain , activity limitation, poor appetite, constipation, ability of family management, fears of disease progress and sleep disorders on psychological pain in patients with cancer pain before and after treatment (P<0.01).The rate of psychological pain in patients with moderate and severe cancer pain was 100%, and the moderate and severe cancer pain was the first influence factors of psychological pain;the second was sleep disorders , and the rate of psychological pain was 90.17%.Conclusions The standardized acesodyne treatment can relieve the psychological pain in patients with cancer pain , which is worthy of clinical promotion and application .