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李明月常永红邓亚玲孟雪晨詹旭蕾方芳.认知行为干预对晚期癌症疼痛患者影响的临床研究[J].,2014,14(34):6732-6736

认知行为干预对晚期癌症疼痛患者影响的临床研究

The Clinical Study on Cognitive Behavior Therapy on Patients withAdvanced Cancer Pain

DOI：

中文关键词: 晚期癌症癌性疼痛认知行为干预生活质量

英文关键词: Advanced Cancer Cognitive behavioral intervention therapy Cancer Pain quality of life

基金项目:中国国家博士后基金面上项目（20100471019）；黑龙江省卫生厅资助项目（2010179）；黑龙江省教育厅项目（1103418）

作者	单位
李明月常永红邓亚玲孟雪晨詹旭蕾方芳	哈尔滨医科大学附属第三医院肿瘤内科；哈尔滨医科大学附属第四医院影像科

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中文摘要:

目的：探讨在临床晚期癌性疼痛患者中，应用认知行为干预的方法，减轻癌痛、改善患者生活质量的可行性。方法：搜集2010 年1 月至2012 年11 月间，于哈尔滨医科大学附属第三医院肿瘤内科收治的晚期癌症患者238 例，包括晚期的肺癌64 例、乳腺癌36 例、胃癌33 例、肝癌29 例、食管癌21 例、大肠癌19 例、胰腺癌14 例、甲状腺癌13 例、鼻咽癌6 例、骨肉瘤3 例，其中发生癌性疼痛的患者214 例，肺癌58 例、乳腺癌34 例、胃癌31 例、肝癌28 例、食管癌18 例、大肠癌17 例、胰腺癌13 例、甲状腺癌9 例、鼻咽癌3 例、骨肉瘤1 例。对晚期癌症伴发癌痛的患者利用行认知行为干预治疗进行治疗干预，30d 为治疗周期，治疗后对晚期癌症患者的生活质量（KPS评分）、癌痛的缓解率的影响。结果：在晚期癌症伴癌痛的患者中，利用认知行为干预后，癌痛总的缓解率为55.6%，其中部分缓解（1～3 级）所占比例为49.5%，完全缓解（4 级）所占比例为6.1%；在不同级别的疼痛（轻～重）中，程度较轻的疼痛缓解率较高（93.2%），程度为中等的疼痛缓解率为67.3%，而重度疼痛缓解率较低（16.7%）；在KPS评分中，238 例患者治疗后评分提高率占67.2%；在生活质量评分改善的患者占69.4%。结论：在晚期癌症伴癌痛的患者中，利用认知行为干预的疗法可以对疼痛程度在轻～中度的癌痛有较好的控制作用，并且对患者的生活质量有提高作用。

英文摘要:

Objective:To investigate feasibility of cognitive behavioral intervention therapy applied in patients with advanced cancer to reduce the cancer pain and improve patient quality of life in the clinic.Methods:238 patients with advanced cancer were collected from January 2010 to November 2012, who accepted therapy in the department of oncology in the third affiliated hospital of Harbin medical university, including 64 lung cancer, 36 breast cacer, 33 gastric cancer, 29 hepatoma, 21 esophageal cancer, 19 colon cancer, 14 pancreatic cancer, 13 thyroid cancer, 6 nasopharynx cancer, 3 osteosarcoma; 214 cases among the 238 patients suffered the cancer pain, including 58 lung cancer, 34 breast cacer, 31 gastric cancer, 28 hepatoma, 18 esophageal cancer, 17 colon cancer, 13 pancreatic cancer, 9 thyroid cancer, 3 nasopharynx cancer, 1 osteosarcoma. Each patient received cognitive behavioral intervention therapy for 30 days. The degree of pain relief and the improvement of quality of life were observed before and after treatment.Results:The results indicated that the total cancer pain relief rate was 55.6%, part relief (degree of 1-3) was 49.5%and entire relief (degree 4) was 6.1%. And the relief rate was 93.2%, 67.3%and 16.7%separately in light, moderate and severe degree of cancer pain. In the KPS, score improved rate accounted for 67.2% in 238 patients after treatment; improvement in quality of life scores accounted for 69.4% of the patients.Conclusion:The study demonstrated that cognitive behavioral intervention therapy is even more effective in light and moderate degree of cancer pain control, and the quality of life was improved in advanced cancer patients after received the therapy.

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