在脊髓转移的患者中,阿片类药物需求与整体存活率之间的关联
Sho Dohzono1, Ryuichi Sasaoka1, Kiyohito Takamatsu1
1Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan.
Spine surgery and related research
|June 13, 2023
概括
脊髓转移的癌症患者的阿片类药物使用与生存时间缩短和脊髓不稳定性增加有关. 较高的阿片类药物剂量 (≥5毫克口服吗啡相当剂/天) 与其他预后因素无关,显著与较差的结果相关.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 疼痛管理 疼痛管理
背景情况:
- 在癌症患者中服用阿片类药物在临床上与生存率降低有关.
- 脊髓转移在癌症护理中是一个重大挑战,通常需要疼痛管理.
- 了解阿片类药物使用对生存和疾病进展的影响至关重要.
研究的目的:
- 研究脊髓转移患者的阿片类药物需求与整体存活率之间的关联.
- 评估阿片类药物剂量与与瘤相关的脊柱不稳定性之间的关系.
主要方法:
- 在2009年2月至2017年5月期间诊断出脊髓转移的428名患者的回顾性分析.
- 分类为阿片类药物需求 (≥5毫克口服吗啡相当剂/天) 和非阿片类药物 (<5毫克OME/天) 组.
- 评估脊柱不稳定性使用脊柱不稳定性瘤评分 (SINS) 和Cox相对危险分析生存.
主要成果:
- 需要更高的阿片类药物剂量 (≥5 mg OME/天) 的患者在诊断后死亡的可能性增加了两倍 (HR 2.13; p<0.001).
- 与非阿片类药物需求组相比,阿片类药物需求组的脊柱不稳定性瘤评分 (SINS) 显著提高 (p<0.001).
- 肺癌是最常见的初级部位 (37%),其次是乳腺癌 (18%) 和前列腺癌 (11%).
结论:
- 脊髓转移患者的阿片类药物需求是短生存时间的独立预测因素.
- 增加的阿片类药物使用与较高程度的瘤相关的脊柱不稳定性相关.
- 这些发现强调了疼痛管理,疾病进展和晚期癌症的生存之间的复杂相互作用.
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