影响肿瘤患者癌痛治疗相关因素的研究进展

摘要

[指示性摘要]疼痛是恶性肿瘤患者最常见、也是最恐惧的症状之一.进展期癌症患者疼痛发生率可高达60％ ～ 80％,严重影响癌症患者的生活质量,对患者的心理也会产生不良影响.目前,中重度癌痛的治疗主要采用药物治疗并遵循世界卫生组织(WHO)的三阶梯镇痛原则,但仍有20％左右的患者疼痛控制不佳.若疼痛控制不佳,会导致患者对治疗的耐受性下降,并影响预后.导致癌痛治疗失败的因素多种多样,目前尚无一致共识.既往肿瘤科医师主要关注肿瘤相关因素对癌痛治疗的影响,主要包括肿瘤的部位、大小、分期、转移的部位、治疗方法等;而随着对“总疼痛”概念的认识加深,非肿瘤因素对癌痛治疗效果的影响也越来越受到关注,包括年龄、性别、受教育程度、职业、收入、心理、社会支持等.本文就进展期肿瘤镇痛治疗影响因素作一综述,为提升癌痛诊疗水平提供参考.%Pain is one of the most common and horrible symptoms in cancer patients.The incidence of pain in advanced cancer patients is as high as 60％ ～ 80％,seriously affecting the quality of life,as well,a negative impact on the patient's psychology.Presently,the moderate and severe cancer pain was mainly treated by medicine and followed the three steps analgesic principle of World Health Organization (WHO),but there were still about 20％ patients with poor pain control.The factors about poor pain control are diverse and no consensus.Oncologists mainly focused on the cancer related factors including tumor location,size,staging,metastasis location,treatment methods and so on.With the deeply understanding of total pain concept,the factors of non cancer-related factors are more and more concerned,including age,gender,the level of education,occupation,income,psychological and social support etc.This article reviews the influencing factors of cancer pain treatment,to provide reference for the improvement of the level of diagnosis and treatment of cancer pain.