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目的探讨姑息性放疗对骨转移患者疼痛及其他常见症状的影响。方法 57例骨转移患者在接受姑息性放疗前1周内及放疗开始后的第1、2、4、8周分别利用ESAS评估以下九条临床症状:疼痛,乏力,恶心,抑郁,焦虑,嗜睡,食欲低下,自我幸福感和气急;记录各时间点的症状分值,用方差分析及Friedman检验进行统计学分析。结果在57例骨转移患者中,至末次随访时间,疼痛、焦虑、嗜睡、食欲低下及自我幸福感五大症状在放疗后得到了明显改善,ESAS评分较前显著降低(均P<0.001),恶心、抑郁、气急三大症状在放疗后改善不明显,ESAS评分较前无显著下降(P值分别为0.821、0.108、0.220),而乏力是唯一恶化的症状,ESAS评分较前显著升高(P=0.001)。结论姑息性放疗能有效改善骨转移患者的疼痛、焦虑、嗜睡、食欲低下及自我幸福感五大常见临床症状,显著提高晚期肿瘤患者的生活质量。
Objective To investigate the effect of palliative radiotherapy on pain and other common symptoms in patients with bone metastases. Methods Fifty-seven patients with bone metastasis underwent ESAS within one week before palliative radiotherapy and at the first, second, fourth and eighth weeks after radiotherapy. The following nine clinical symptoms were evaluated: pain, fatigue, nausea, depression, anxiety, Low appetite, self-esteem and shortness of breath. The scores of symptoms at each time point were recorded and analyzed by ANOVA and Friedman test. Results In the 57 patients with bone metastases, the five symptoms of pain, anxiety, drowsiness, poor appetite and self-efficacy were significantly improved after radiotherapy to the last follow-up time. The ESAS score was significantly lower than before (both P <0.001) , The three major symptoms of depression and shortness of breath did not improve obviously after radiotherapy. The ESAS score was not significantly lower than before (P values were 0.821,0.108,0.220 respectively), while fatigue was the only worsening symptom. ESAS score was significantly higher than before (P = 0.001). Conclusion Palliative radiotherapy can effectively improve the five common clinical symptoms of pain, anxiety, drowsiness, loss of appetite and self-efficacy in patients with bone metastases, and significantly improve the quality of life of patients with advanced cancer.