Symptoms Associated with Malignant Wounds: A Prospective Case Series
Symptoms Associated with Malignant Wounds: A Prospective Case Series
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DOI：
10.1016/j.jpainsymman.2008.01.009
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发表时间：
2009-02-01
影响因子：
4.7
通讯作者：
Trozzolo, Linda
中科院分区：
文献类型：
--
作者：
Maida, Vincent;Ennis, Marguerite;Trozzolo, Linda
很大一部分癌症患者会出现恶性伤口。恶性伤口通常无法愈合，只能采用姑息疗法。姑息性伤口护理包括此类伤口的疼痛和症状管理。472例癌症患者中的67例来自姑息医学咨询的前瞻性连续病例系列，在转诊时表现出恶性伤口，并进行了研究，以确定与恶性伤口相关的最常见症状和解剖部位。数据收集自患者自己报告的多达三种伤口相关症状。总体而言，67.7%的恶性伤口与以下八种症状中的至少一种相关：疼痛、肿块效应、美学困扰、渗出、气味、瘙痒、出血和结痂; 21.9%的伤口与两种或两种以上症状相关; 11.5%的伤口与三种症状相关。症状点患病率为疼痛31.3%，肿块效应23.9%，审美不适19.4%，渗出17.9%，气味11.9%，瘙痒6%，出血6%，结痂1.5%。乳腺癌患者的恶性伤口患病率最高（47.1%）。胸壁和乳房是31.2%的伤口部位。会阴部和生殖器出现的症状/伤口比率最高（2.2）。本研究的结果反映了恶性伤口与显著的症状负担相关，并强调了对症状进行全面临床评估和评价的必要性。需要进一步的研究来确定恶性伤口疼痛和症状管理的最佳方法。J Pain Symptom Manage 2009;37：206-211. (c)2009年美国癌症疼痛缓解委员会。爱思唯尔公司出版All rights reserved.
A significant proportion of cancer patients develop malignant wounds. Malignant wounds are generally nonhealable and are managed with palliative methods. Palliative wound care encompasses the pain and symptom management of such wounds. Sixty-seven of 472 cancer patients from a prospective sequential case series of palliative medicine consultations demonstrated malignant wounds at the time of referral and were studied to determine the most common symptoms and anatomic sites associated with malignant wounds. Data were collected from patients' own reports of up to three wound-related symptoms. Overall, 67.7% of malignant wounds were associated with at least one of the following eight symptoms: pain, mass effect, esthetic distress, exudation, odor, pruritus, bleeding, and crusting; 21.9% of wounds were associated with two or more symptoms; and 11.5 % of wounds were associated with three symptoms. The symptom point prevalence was 31.3% for pain, 23.9 % for mass effect, 19.4 % for esthetic distress, 17.9% for exudation, 11.9% for odor, 6% for pruritus, 6% for bleeding, and 1.5% for crusting. Breast cancer patients had the highest prevalence of malignant wounds (47.1%). The anterior chest wall and breast was the site of 31.2% of wounds. The perineum and genitalia presented with the highest ratio of symptoms per wound (2.2). The results of this study reflect that malignant wounds are associated with a significant symptomatic burden, and reinforces the need for thorough clinical assessment and evaluation of symptoms. Further research is required to define the optimal methods of pain and symptom management for malignant wounds. J Pain Symptom Manage 2009;37:206-211. (c) 2009 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.