医护宣教和锶-89联合鲑鱼降钙素喷鼻剂治疗恶性肿瘤骨转移骨痛的效果研究

Effect of physician-nursing education, strontium-89 combined with salmon calcitonin nasal spray in the treatment of malignant tumors patients with bone metastatic pain

  • 摘要:
      目的  探讨锶-89(89Sr)联合鲑鱼降钙素喷雾剂治疗恶性肿瘤骨转移骨痛的临床疗效。
      方法  将129例晚期恶性肿瘤骨转移患者分为研究一组、研究二组与对照组,各43例。研究一组采用89Sr联合鲑鱼降钙素喷雾剂治疗合并医护宣教,研究二组采用89Sr联合鲑鱼降钙素喷雾剂治疗,对照组仅采用89Sr治疗。比较3组的疼痛治疗效果、骨转移灶治疗效果、血锶、钙浓度的变化,治疗6个月后,采用症状自评量表(SCL-90)、综合医院焦虑/抑郁情绪测定表(HADS)、家庭功能评定量表(FAD)进行评测。
      结果  治疗后1、3、6个月,研究一组的疼痛治疗有效率显著高于研究二组,研究二组则显著高于对照组(P < 0.05); 研究一组的骨转移灶治疗有效率显著高于研究二组,研究二组则显著高于对照组(P < 0.05); 研究一组的血锶浓度治疗显著低于研究二组,研究二组则显著低于对照组(P < 0.05); 治疗后,研究一组的血钙浓度显著低于研究二组,研究二组则显著低于对照组(P < 0.05)。研究一组的SCL-90各项目评分均显著低于研究二组,研究二组的各项目评分均显著低于对照组(P < 0.05); 研究一组的焦虑、抑郁发生率显著低于研究二组与对照组(P < 0.05), 而研究二组与对照组间无显著差异(P>0.05); 研究一组的焦虑、抑郁得分和得分≥8分者占比均显著低于研究二组,研究二组则显著低于对照组(P < 0.05); 研究一组的FAD各项目评分均显著低于研究二组和对照组(P < 0.05), 但研究二组和对照组间各评分无显著差异(P>0.05)。
      结论  89Sr联合鲑鱼降钙素喷鼻剂和医护宣教应用于恶性肿瘤骨转移骨痛的治疗中,疗效显著,可改善患者的生活质量。

     

    Abstract:
      Objective  To study the clinical efficacy of strontium-89 (89Sr) combined with salmon calcitonin spray in the treatment of malignant tumors patients with bone metastatic pain.
      Methods  A total of 129 advanced malignant tumors patients with bone metastases were divided into study 1 group, study 2 group and control group. Study 1 group (n=43)was treated with 89Sr combined with salmon calcitonin spray as well as physician-nursing education, and study 2 (n=43) was treated with 89Sr combined with salmon calcitonin spray, while the control group (n=43) was only treated with 89Sr. The therapeutic effects on pain and bone metastases, changes in blood strontium and calcium levels were compared between the three groups. After 6 months of treatment, Symptom Checklist-90(SCL-90), General Hospital Anxiety/Depression Scale(HADS) and Family Assessment Device(FAD) were used to measure the conditions of patients.
      Results  After treatment, the effective rate of pain treatment in study 1 group was higher than that in study 2 group, which was higher than that in control group (P < 0.05); the effective rate of bone metastasis treatment was highest in study 1 group, and lowest in the control group (P < 0.05); the concentrations of blood strontium and calcium were the lowest in study 1 group and highest in the study 1 group(P < 0.05). The scores of SCL-90 was the lowest in the study 1 group, and highest in control group (P < 0.05). The incidence of anxiety and depression in study 1 group was lower than that in study 2 group and control group (P < 0.05), but there was no difference between study 2 group and control group (P>0.05); the proportions of patients with moderate and severe anxiety and depression and their scores ≥8 points in study 1 group was lower than that in study 2 group that was lower than that of the control group at the same time(P < 0.05); the item scores of FAD in study 1 group were lower than that of study 2 (P < 0.05), but there was no difference between study 2 group and the control group (P>0.05).
      Conclusion  Strontium 89 combined with salmon calcitonin nasal spray and medical and nursing education has obvious curative effect on bone metastasis and bone pain of malignant tumors, which has certain clinical popularization value.

     

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