1.Efficacy of percutaneous vertebroplasty with radiotherapy for bone metastasis pain
Xianjiang CHENG ; Yuejuan SHAO ; Kun WANG
Chinese Journal of Clinical Oncology 2016;43(9):371-375
Objective:To compare efficacy of percutaneous vertebroplasty (PVP) with radiotherapy and radiotherapy alone for bone me-tastasis pain. Methods:A total of 247 bone metastasis patients with pain were analyzed. The radiotherapy group comprised 158 cases, whereas the combination group comprised 89 cases. We mainly observed the effect of pain treatment, behavioral states, and im-proved emotional condition. The side effects and complications were also investigated. Daily medicine consumption of background pain treatment was observed between the two groups. Analysis was done by SPSS 17.0 statistical software. Numerical variables were analyzed using t test and comparisons between groups used chi-square test. Results:The VAS scores of radiotherapy group decreased from 8.12±1.45 to 3.06±1.68 after treatment (P<0.05), and combination group VAS scores from 8.46±1.73 to 2.45±1.47 (P<0.05). The time to pain relief following PVP and radiotherapy were 1.63±0.81 and 8.56±2.87 days, respectively (P<0.001). The breakthrough pain frequency was 4.56 ± 1.98 times/day, which decreased to 1.57 ± 0.98 times/day after PVP (P<0.05). By contrast, the breakthrough pain frequency was 4.73±2.24 times/day before treatment, which decreased to 3.56±1.56 times/day after radiotherapy. No serious compli-cations were observed in the two groups. The depression and anxiety mood in the combination group improved after treatment. Daily medicine consumption in radiotherapy group increased after therapy. However, daily medicine consumption in combination group was reduced after therapy. Conclusion:PVP with radiotherapy can effectively relieve bone metastasis pain and improve patients' quality of life and it is worthy of promotion in clinical practice.
2.Clinical therapeutic effect of Neurotropin combined with oxycodone hydrochloride for neuropathic cancer pain
Xianjiang CHENG ; Weishuai LIU ; Kun WANG
Chinese Journal of Clinical Oncology 2015;42(11):546-549
Objective:To investigate the clinical efficacy of Neurotropin combined with oxycodone hydrochloride in moderating the severe pain in neuropathic cancer pain (NCP) patients. Methods: NCP patients who received drug therapy with a visual analog scale (VAS) score of>4 were randomly divided into the placebo combined oxycodone group (group A) and Neurotropin combined oxy-codone group (group B). The VAS score, pain relief rate, frequency of pain outbreaks, average dose of oxycodone per day, and adverse drug reactions between the two groups were compared. Results:The VAS scores in groups A and B both had significant reduction after treatment (P<0.05), whereas the VAS score in group B after 14 days of treatment decreased more significantly than that in group A (P=0.03). The pain relief rate in group B patients 14 days after treatment was significantly higher than that in group A (P<0.001). The out-break pain in groups A and B 7 and 14 days after treatment significantly decreased, whereas the outbreak pain in group B was signifi-cantly lower than that in group A (P values were 0.07 and 0.07, respectively). The average dose of oxycodone per day in group B 14 days after treatment was lower than that in group A (P<0.001). Adverse reactions, such as nausea and vomiting, in group B were signifi-cantly less than those in group A (P<0.05). Conclusion:Neurotropin combined with oxycodone can effectively lower the NCP, average dose of oxycodone per day, and adverse reactions.
3.Efficacy of flurbiprofen axetil for treatment of break-through pain in patients with metastatic bone cancer pain
Kun WANF ; Jianlei HAO ; Yuejuan SHAO ; Xianjiang CHENG ; Bingqing GUAN ; Zhe YAN
Chinese Journal of Anesthesiology 2013;33(8):913-915
Objective To evaluate the efficacy of flurbiprofen axetil for treatment of break-through pain (BTP) in patients with metastatic bone cancer pain.Methods Ninety-seven patients with metastatic bone cancer pain complicated with BTP were randomly divided into morphine group (M group,n =51) and flurbiprofen axetil group (F group,n =46).In group M,immediate release morphine sulfate was given orally,and the single dose for pain relief was about 10% to 15% of the daily slow-release dose,and the administration was repeated until BTP was relieved.In group F,flurbiprofen axetil 50 mg was infused intravenously over 30 min,and the maximum dose was 150 mg.The BTP frequency was recorded within one month after the first BTP relief.The drug consump-tion for treatment of primary cancer pain,and adverse reaction were recorded.Results The onset time of flurbiprofen axetil and immediate release morphine sulfate was (18± 9) and (35± 11) min,respectively (P < 0.05).The onset time of BTP treatment was significantly shorter,and the incidence of constipation was lower in group F than in group M (P < 0.05).There was no statistical significance in the BTP frequency between the two groups (P > 0.05).As compared with that before BTP treatment,the drug consumption for treatment of primary cancer pain was significantly increased after treatment in group M (P < 0.05) and no significant changes were found after treatment in group F (P > 0.05).Conclusion Flurbiprofen axetil is safer and more effective in relieving BTP in patients with metastatic bone cancer pain than immediate release morphine sulfate,and it does not affect the drug tolerance for treatment of primary pain.
4.A survey of cancer pain management among hospitalized elderly patients
Yuejuan SHAO ; Jianlei HAO ; Xianjiang CHENG ; Kai JI ; Bingqing GUAN ; Kun WANG
Chinese Journal of General Practitioners 2015;14(5):384-387
To explore the status of cancer pain management among hospitalized elderly patients.Pain intensity,use of analgesic drugs and incidence of adverse reactions were surveyed for 620 cancer pain patients.And 218 of them were aged over 65 years.The proportions of mild,moderate and severe pain were 29.8%,36.2% and 34.0% respectively.And the corresponding rates in young and middle-aged patients were 28.4%,34.8% and 36.8% respectively (P > 0.05).In elders with cancer pain,28% used no analgesic.For severe pain patients,only 71.6% received potent opioids and 5.4% nonsteroidal antiinflammatory drugs.And the corresponding rates in young and middle-aged patients were 26.1%,73.0% and 4.7% respectively (P > 0.05).The rates of constipation,dysuria and delirium in elderly patient group were higher than young and middle-aged patient group (P < 0.05).Pain management is unsatisfactory and rational uses of analgesic drugs should be strengthened for preventing the relevant adverse reactions.
5.Application of folding transfer shelf in the transportation of critically ill patients
Xianjiang WANG ; Junya CHENG ; Jie HUANG ; Dongmei YANG ; Yunchao SHI ; Huijie YU
Chinese Critical Care Medicine 2020;32(9):1125-1127
Objective:To explore the application of folding transfer shelf in the transportation of critically ill patients.Methods:Patients transferred from the emergency department to the intensive care unit (ICU) admitted to the First Hospital of Jiaxing from January 1st to December 31st in 2019 were enrolled. The patients were divided into study group and control group by whether or not using the self-developed folding transfer shelf. The incidence of adverse events, the stability rate of vital signs and the transport time were compared between the two group.Results:A total of 437 patients were enrolled in the study, with 222 in the study group (which used the self-developed folding transfer shelf) and 215 in the control group (which used the conventional stretcher). The baseline data such as gender, age, disease status and disease severity were balanced between the two groups. The stability rate of vital signs in the study group was higher than that in the control group (89.19% vs. 82.33%, P < 0.05). The transfer time in the study group was shorter than that in the control group (minutes: 6.39±1.35 vs. 7.61±1.34, P < 0.01). The total incidence of adverse transport events in the study group was lower than that in the control group (2.25% vs. 10.23%, P < 0.01). The incidence of miscarriage of emergent materials and instrument falling in the study group were lower than those in the control group (0% vs. 2.79%, 0% vs. 2.33%, both P < 0.05). Conclusions:The folding transfer shelf could reduce the transport risk of critical ill patients, especially the risk of miscarriage and falling of rescue instrument. The application of folding transfer shelf could regulate the management of transport, keep the vital signs of patients stable during transport, shorten the transport time, and facilitate an efficient and high-quality transport.