老年晚期恶性肿瘤患者疼痛特征分析

目的分组了解中青年和老年晚期恶性肿瘤患者疼痛的特点，分析老年肿瘤疼痛患者疼痛评分与疼痛部位、性质及所致影响问的相关性。方法共收集127例晚期恶性肿瘤伴疼痛的患者，对其进行全面疼痛评估，分为中青年组和老年组进行比较，并对老年组资料进行相关性分析。结果患者最高疼痛评分96．8％属中重度疼痛，平均疼痛评分88．2％属轻度疼痛，疼痛部位以腹、腰、背、肩颈为主，性质通常为间歇痛、钝痛、刺痛、胀痛等。疼痛对睡眠、食欲、活动能力、情绪及人际关系均造成不良影响，中青年组和老年组比较差异无统计学意义。老年组中，平均疼痛评分与转移部位数、疼痛部位数、背部疼痛、臀髋部疼痛、酸痛、胀痛及焦虑之间呈正相关，与缓解因素之不触碰呈负相关。最高疼痛评分与疼痛部位数、胸痛、绞痛、加重因素之触碰、入睡困难及抑郁呈正相关，与无明确加重因素呈负相关。结论晚期恶性肿瘤合并疼痛者中重度疼痛发生率高，全面地评估、控制及治疗疼痛是提高晚期肿瘤疼痛患者，尤其是老年患者生活质量的关键措施。

The pain characteristics of the elder advanced cancer patients

Objective To describe the pain characteristics and experiences among younger and elder cancer patients in order to explore the correlationship between pain intensity and pain characteristics. Methods The data on pain intensity, location, kind, mitigating and aggravating factors as well as pain interference from a comprehensive pain assessment were collected among a total of 127 advanced cancer patients with pain. The data from younger to elderly patients were compared. And correlation analyses were estimated for the elderly. Results 96.8% of the patients obtained worst pain scores in the moderate-severe range. 88.2 % of the average pain scores were zero or in the mild range. The differences between younger and elderly patients were not statistically significant. Of the elderly advanced cancer patients, the average pain scores were positively correlated with number of metastatic sites, number of pain locations, upper back pain, hip pain, soreness, di- stending pain and anxiety, while negatively correlated with no-touch, one of the mitigating factors. The worst pain scores were positively correlated with number of pain locations, chest pain, colic, touch which increased pain intensity, difficulty falling asleep and depression. Conclusion The prevalence of moderate-severe pain is high in elderly advanced cancer patients with pain, which is seriously affecting their quality of life.