国际肿瘤学杂志 ›› 2015, Vol. 42 ›› Issue (12): 946-949.doi: 10.3760/cma.j.issn.1673-422X.2015.12.017

• 综述 • 上一篇    下一篇

癌性神经病理性疼痛的发病机制、临床评估及治疗

刘维帅,邵月娟,王昆   

  1. 300060 天津医科大学肿瘤医院疼痛治疗科 国家肿瘤临床医学研究中心 天津市肿瘤防治重点实验室
  • 出版日期:2015-12-08 发布日期:2015-11-10
  • 通讯作者: 王昆 E-mail:wangk1128@sina.com
  • 基金资助:

    国家自然科学基金(81201065);天津医科大学肿瘤医院院级科研种子基金(1419)

Pathogenesis, clinical evaluation and treatment of neuropathic cancer pain

Liu Weishuai, Shao Yuejuan, Wang Kun   

  1. Department of Pain Management, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
  • Online:2015-12-08 Published:2015-11-10
  • Contact: Wang Kun E-mail:wangk1128@sina.com

摘要: 癌性神经病理性疼痛(NCP)是肿瘤患者由于外周或者中枢神经系统或者神经传导系统受到物理性或化学性损伤引起的疼痛,其发病机制包括肿瘤压迫引起的神经痛、手术与放化疗等治疗引起的神经痛、副瘤综合征引起的神经痛以及炎症等其他因素引起的神经痛。详细的病史询问、仔细的体格检查是诊断NCP的重要手段,其临床评估应使用标准化的疼痛评估量表。目前,NCP的治疗主要包括阿片类为主的药物联合辅助镇痛药物、介入治疗和基因治疗。针对NCP的发病机制决定治疗策略,多学科协作、联合不同止痛药物及技术手段是治疗NCP的方向。

关键词: 肿瘤, 神经痛, 诊断, 治疗

Abstract: Neuropathic cancer pain (NCP) arises from physical or chemical damage to peripheral or central neurons or in the neural conduction system. The mechanisms of NCP include pain directly related to tumor involvement, pain associated with chemotherapy, radiotherapy and surgery, neuropathic syndromes associated with paraneoplastic syndromes, inflammation and other factors. A detailed history and careful physical examination are important means of diagnosis of NCP. The clinical evaluation of NCP should use standardized pain assessment scale. Till now, the treatments of NCP include opioid combined with auxiliary analgesic drugs, interventional treatment and gene treatment. Deciding treatment strategies according to the pathogenesis of NCP, multidisciplinary collaboration, combined therapy with different analgesic drugs and technologies are the therapeutic directions for NCP.

Key words: Neoplasms, Neuralgia, Diagnosis, Therapy