A Descriptive Study of Spinal Cord Compression in Patients Under Palliative Care

安寧照顧病患脊髓轉移的描述型研究

賴鈺嘉(Yu-Jia Lai) ； 林昌錡(Chang-Chyi Lin)

《The Changhua Journal of Medicine》 6卷2期 (2001/04) Pp. 79-83

摘要

背景：脊髓轉移是癌病最嚴重的後遺症之一，許多治療方法都被採用，包括：使用類固醇、化學治療、放射治療及手術治療。但是，我們對於在台灣的此類病人之存活狀態與疼痛的緩解情形並不清楚，本研究的目地在於評估此類病人的存活狀態與疼痛的緩解情形。
材料與方法：從1996年7月到1998年5月，共有38位經由核磁共震造影或電腦斷層檢查的脊髓轉移癌症病人被選進來研究，這些人為接受住院或居家照顧的安寧療護病患。本研究使用病歷調查與電話訪問來確認他們的存活狀態與疼痛的緩解情形。我們以Kaplan-Meier Survival Rate來描述其存活時間。
結果：脊髓轉移的位置依次為：胸椎(29/38)，腰薦椎(7/38)，頸椎(2/38)；整體的存活中位時間為2.1個月，除了年紀之外，存活率在下列三個分群並無差異性存在：(l)性別、(2)轉移位置、(3)有無接受嗎啡、化學治療、放射治療或手術治療。關於疼痛的緩解情形，有四位病人雖經治療仍有嚴重的疼痛。
結論：一般而言，接受安寧療護照顧的脊髓轉移癌症病人，其分群之間存活率並無差異性存在，疼痛的控制則大部份的病人均可達於理想。

關鍵字

脊髓轉移 ； 安寧療護

並列摘要

Background: Spinal cord compression is one of the most severe oncological complications. Various modalities of treatments, including steroids, chemotherapy, radio-therapy, and surgery, have been used, but we do not know exactly the survival condition and the effects of pain relief in this group of patients in Taiwan. The purpose of this study is to evaluate the survival rate and pain relief among them.
Materials and Methods: From July 1996 to May 1998, 38 cancer patients with spinal cord compression were recruited who were confirmed by MRT or CT-scan, which included both home-based and hospital-based cases under palliative care. Survey of medical charts and telephone inquiries were used to certify their survival and pain condition.
Results: The levels of spinal cord compression are T-spine (29/38), L-S-spine (7/38), and C-spine (2/38) subsequently. The overall median survival time is 2.1 months. Except age, there were no significant differences in survival rates between (1)sexes, (2)levels of compression, (3)patients with or without morphine, chemotherapy, radiotherapy, or surgery. With regards to pain relief, only four patients were suffered from severe pain despite treatment.
Conclusion: In general, there are no significant differences in survival rates between subgroups with spinal cord compression who are under palliative care. Pain control can be optimal in most patients.

並列關鍵字

spinal cord compression ； palliative care