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目的:调查上海市医师对癌症疼痛的认识和治疗现状。方法:2007年1—3月对上海市106所二、三级医院1 982名医师进行癌痛治疗知识及治疗情况的问卷调查并进行统计学分析。结果:对“三阶梯止痛”治疗方案,52.3%的医师表示非常了解,比1999年上升了21.6个百分点,肿瘤科医师的了解程度明显好于非肿瘤科医师;16.8%的医师对镇痛治疗剂量滴定的3个主要原则回答完全正确,肿瘤科医师回答的正确率高于非肿瘤科医师;强阿片类药物成为医师治疗重度癌痛的首选药物,应用杜冷丁治疗重度癌痛的比率下降;74.8%的患者通过治疗能使疼痛明显减轻,比1999年上升了25.4个百分点;81.1%的医师肯定疼痛治疗效果,肿瘤科医师对治疗效果更为乐观;93.3%的医师认为有必要继续开展癌痛治疗知识的培训,其中非肿瘤科医师的需求更高。医院和政策法规限制过严是目前使用止痛药物的主要障碍。结论:医师对癌痛的认识和诊治水平较1999年有较大提高,但仍需进一步开展癌痛治疗知识的培训,推广规范性治疗并消除止痛药物的用药障碍。
OBJECTIVE: To investigate the current situation of Shanghai doctors’ understanding and treatment of cancer pain. Methods: From January to March 2007, questionnaires of knowledge and treatment of cancer pain treatment among 1 982 doctors in 106 second and third level hospitals in Shanghai were collected and statistically analyzed. Results: 52.3% of physicians knew well and were 21.6% more than 1999, and oncologists had a better understanding than non-oncologists, and 16.8% of physicians learned from the treatment of “three-step analgesics” The three main principles of pain-titration titration were completely correct, and oncologists responded more correctly than non-oncologists; strong opioids became the physician’s first choice for the treatment of severe pain, and the ratio of dolantin to severe pain was high Decreased; 74.8% of patients through treatment can make the pain significantly reduced, up 25.4 percentage points over 1999; 81.1% of the physicians affirmed the effect of pain treatment, oncologists more optimistic about the treatment effect; 93.3% of physicians think it is necessary to continue The training of cancer pain treatment knowledge, including non-oncologists need higher. Harsh hospital and regulatory restrictions are major barriers to the use of painkillers. Conclusion: Physicians’ knowledge and diagnosis and treatment of cancer pain have been greatly improved compared with that of 1999. However, further training on the knowledge of cancer pain treatment is needed, normative treatment should be promoted, and the medication dysfunction of painkiller drugs should be eliminated.