Assessment of cancer pain: A prospective evaluation in 2266 cancer patients referred to a pain service
Assessment of cancer pain: A prospective evaluation in 2266 cancer patients referred to a pain service
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DOI：
10.1016/0304-3959(95)00076-3
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发表时间：
1996-01-01
期刊：
影响因子：
7.4
通讯作者：
Lehmann, KA
中科院分区：
文献类型：
--
作者：
Grond, S;Zech, D;Lehmann, KA
尽管疼痛评估是令人满意地控制癌症疼痛的重要初步步骤，但有关不同疼痛综合征患病率的数据却很少。在一项针对 2266 名癌症患者的前瞻性研究中，我们评估了疼痛综合征的定位、病因和病理生理机制。 30% 的患者出现 1.39% 的患者出现 2 种疼痛症状，31% 的患者出现 3 种或更多不同的疼痛症状。大多数患者的疼痛是由癌症（85%）或抗肿瘤治疗（17%）引起的； 9% 的疼痛与癌症相关，9% 的疼痛则与癌症无关。疼痛可分为源自骨骼（35％）、软组织（45％）或内脏结构（33％）中的伤害感受器或神经源性疼痛（34％）。在大多数患者中，疼痛综合征位于下背部（36%）、腹部（27%）、胸部（23%）、下肢（21%）、头部（17%）和骨盆区域（15%）。主要疼痛综合征也根据 IASP 慢性疼痛分类进行编码。受主要疼痛综合征影响的区域和系统根据癌症起源部位的不同而表现出很大的差异，而时间特征、强度和病因并不受癌症部位的显着影响。我们对患者评估的各种疼痛综合征证实了治疗前全面疼痛评估的重要性。
Although pain assessment is a vital preliminary step towards the satisfactory control of cancer pain, data on the prevalence of different pain syndromes are rare. In a prospective study of 2266 cancer patients, we assessed localisations, aetiologies and pathophysiological mechanisms of the pain syndromes. Thirty percent of the patients presented with 1,39% with 2 and 31% with 3 or more distinct pain syndromes. The majority of patients had pain caused by cancer (85%) or antineoplastic treatment (17%); 9% had pain related to cancer disease and 9% due to aetiologies unrelated to cancer. Pain could be classified as originating from nociceptors in bone (35%), soft tissue (45%) or visceral structures (33%) or otherwise as of as neuropathic origin (34%). In most patients, pain syndromes were located in the lower back (36%), abdominal region (27%), thoracic region (23%), lower limbs (21%), head (17%) and pelvic region (15%). The main pain syndrome was also coded according to the IASP Classification of Chronic Pain. Regions and systems affected by the main pain syndrome showed large variation depending on the site of cancer origin, whereas temporal characteristics, intensity and aetiology were not markedly influenced by the cancer site. The variety of pain syndromes evaluated in our patients confirms the importance of comprehensive pain assessment prior to treatment.