| Objective:To explore the therapeutic effect of opioids on patients with advanced cancer and the influencing factors of cancer pain in patients.Methods:A retrospective analysis was performed on 200 patients with advanced tumors who underwent cancer pain treatment in our hospital's pain clinic from September 2018 to December 2019.There were 113 males and 87 females.The patients were grouped according to the treatment drugs,that is,the opioid group and the non-opioid group.The pain intensity scores of the two groups of patients were scored using the numerical rating scale NRS.The physical status of the two groups of patients was evaluated by the KPS scores,KPS scores are based on a percentile score system;patients are given QOL quality of life scores before and after administration of medication;patient adverse events are recorded;factors affecting cancer pain are analyzed,and survival curves are drawn;SPSS20.0 analysis software to analyze the data.Results:Patients in the opioid group had an NRS score of 5.49±1.12 before treatment,NRS score of 1.32±0.58 after treatment,patients in the non-opioid group had an NRS score of 5.25±0.36 before treatment,and NRS score of 1.94±0.63 after treatment.There was no statistically significant difference in the pain scores of the patients before treatment(P>0.05).The scores of the opioid group after treatment were lower than those of the non-opioid group.There was a statistical difference between the two groups(P<0.05);After that,there were 4 patients without remission in the non-opioid group,accounting for 5.56%,6 patients with mild remission,accounting for 8.33%,41 patients with moderate remission,accounting for 56.94%,19 patients with obvious remission,accounting for 26.39%,and 2 patients with complete remission,accounting for 2.78%.The effective response rate was 86.11%;0 patients in the opioid group had no remission,accounting for 0.00%,7 patients had mild remission,accounting for 5.47%,58 patients had moderate remission,accounting for 45.31%,61 patients had obvious remission,accounting for 47.669%,complete remission 2 cases,accounting for 1.56%.The effective remission rate was 94.53%;there was a statistical difference between the effective remission rate of the two groups P<0.05;after investigation and study,the adverse reactions and incidence of patients in the opium group were 116 cases of constipation,accounting for 90.63%,nausea,vomiting 37 cases,accounting for 28.91%,15 cases of drowsiness and excessive sedation,accounting for 11.72%,4 cases of urinary retention,accounting for 3.13%;12 cases of respiratory depression,accounting for 9.38%,89 cases of drug dependence,accounting for 69.53%,3 cases of itching,accounting for 2.34%.Among them,the incidence of constipation is the highest,followed by drug dependence.In the non-opioid group,adverse reactions and incidences were 46 cases,accounting for 63.87%,52 cases of fatigue,72.22%,12 cases of hyperhidrosis,accounting for 16.67%,and 13 cases of constipation,accounting for 18.05%,of which the incidence of fatigue was the highest.Patients with nausea occurred second;the KPS score of the opioid group before treatment was 43.66±6.32,and the post-treatment score was 65.26±5.65.There was a statistical difference in KPS score before and after treatment(P<0.05);the non-opioid group was 42.97±6.28 before treatment.After 53.50±7.25.There were statistical differences in KPS scores before and after treatment(P>0.05);there was no statistical difference in KPS scores between the two groups of patients before treatment(P>0.05).The KPS scores of the two groups of patients after treatment were significantly higher than those of non-opioid.There was a statistical difference between the two groups(P<0.05).The quality of life score of the opioid group before treatment was 33.23±6.35,and the score after treatment was 55.36±5.25.There was a statistical difference in the quality of life score before and after treatment(P<0.05);The non-opioid group was 32.37±6.26 before treatment and 45.53±7.35 after treatment.The quality of life scores before and after treatment were statistically different(P<0.05);the quality of life scores of the two groups of patients before treatment were not statistically different(P>0.05).The quality of life scores of the two groups of patients were significantly higher after treatment in the opioid group.In the non-opioid group,there is a statistical difference(P<0.05);the factors that may affect patient's cancer pain are analyzed,and the possible factors are selected,including gender,age,occupation,education,understanding of the disease,and past related medical history,previous cancer treatment history,previous pain treatment history,metastasis situation,cause of pain,pain nature,degree of pain before treatment,KPS before treatment,QOL before treatment,tumor staging,vascular invasion,nerve invasion,lymph node metastasis,etc.,first The Cox risk model was used to analyze multiple single factors.At the level of ?=0.05,the analysis showed that the impact of cancer pain such as metastasis,QOL score before treatment,degree of differentiation,vascular invasion,neural invasion,and lymph node metastasis factors(p<0.05);gender,age,occupation,education level,knowledge of the disease,past related medical history,previous cancer.There is no statistical significance in the results of univariate analysis(p>0.05)in the history of symptomatic treatment,history of previous pain treatment,cause of pain,pain nature,degree of pain before treatment,and KPS before treatment.The statistically significant single factor indicators mentioned above were included in the Cox risk model.After analysis,a total of 6 factors with statistical significance(p<0.05)entered the Cox model,including:lymph node metastasis,QOL,degree of differentiation,vascular invasion,nerve invasion,and metastasis;QOL score,degree of differentiation,vascular invasion,nerve invasion,and lymph node metastasis before treatment are risk factors that affect the prognosis of patients with cancer pain,including regression coefficients of degree of differentiation,vascular invasion,nerve invasion,and metastasis ? is less than 0,indicating that when the degree of differentiation,vascular invasion,nerve invasion,metastasis and other conditions are low,the patient's pain situation will be reduced accordingly.The regression coefficient? of lymph node metastasis and QOL score is greater than 0,indicating that when the lymph node metastasis and QOL score are severe,the patient's pain increases.From the survival table and survival curve,we can see that patients who use opioids have a longer survival time.Conclusion:The analgesic effect of opioids is better than that of non-opioids,and it is better than that of non-opioids in terms of patient analgesia and remission rate.In addition,the quality of life and KPS score of patients are also due to non-opioid group.However,the side effects caused by opioids are also large.Therefore,when treating cancer pain,the individual situation of the patient should be considered.In addition,metastasis,QOL score before treatment,degree of differentiation,vascular invasion,nerve invasion,and lymph node metastasis are caused.The single factor of cancer pain,QOL score before treatment,degree of differentiation,vascular invasion,nerve invasion,and lymph node metastasis are risk factors that affect the prognosis of patients with cancer pain. |
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