癌症疼痛

A. Hum, R. Lee
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摘要

1986年,世界卫生组织(WHO)发表了一份题为《慢性癌症患者权利宣言》的文件,其中说,根据WHO的说法,三级镇痛阶梯应该足以缓解70-90%的患者的疼痛。然而,尽管越来越重视评估和管理,疼痛仍然是癌症患者的普遍症状。这就是为什么对每个活跃的从业者来说,癌症疼痛知识的更新是必要的。本章概述了目前对癌症疼痛的理解。分析了癌痛综合征在急性和慢性之间,以及在各种原因之间的发生。癌症疼痛评估是临床医师面临的挑战。对于癌症疼痛的治疗,多模式方法的原则被使用。详细介绍的药物治疗包括阿片类药物的合理使用。癌症疼痛患者的姑息治疗备受关注,并提出了基于临终关怀的姑息治疗模式。详细介绍了突破性癌症疼痛管理的新技术,包括针对患者的特殊问卷。癌症幸存者的疼痛治疗和全科医生在癌症疼痛问题中的作用是本章提出的新主题。
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CANCER PAIN
In 1986, the World Health Organization (WHO) has published a document entitled “A Declaration of the Rights of Patients with Chronic Cancer,” which says that according to the WHO, three-step analgesic ladder pain relief should be adequate for 70–90% of patients. However, despite increased attention on assessment and management, pain continues to be a prevalent symptom for patients with cancer. That is why refreshment of knowledge in cancer pain is necessary for every active practitioner. Broad overview of current understanding in cancer pain is presented in the chapter. Cancer pain syndromes are analyzed in between acute or chronic, and in among various causes occurred. Cancer pain assessment was presented with challenges meeting clinical practitioners. For cancer pain treatment, principles of multimodal approach are used. The pharmaceutical treatment presented in detail included rational use of opioids. Big attention is paid on palliative care of cancer pain patients and hospice-based palliative care model is presented too. New tech-nologies of breakthrough cancer pain management are disclosed in detail including special questionnaire for patients. Cancer survivors’ pain treatment and general practitioner’s role among cancer pain problems are new topics presented in the chapter.
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