Bausewein C
Städtisches Krankenhaus München-Harlaching.
Z Arztl Fortbild Qualitatssich. 2000 Sep;94(7):569-73.
Nausea and vomiting are the most distressing gastrointestinal symptoms in patients with far advanced malignant diseases. A complex pathophysiology exists between gastrointestinal tract and brainstem. Neurotransmitters play an important role. An exact history and physical examination are necessary for the choice of the antiemetic. Dependent on the cause the antiemetic, which blocks receptors peripherally or centrally, will be chosen. Main antiemetic groups are prokinetics, 5HT3-antagonists, dopaminantagonists, antihistaminics and phenothiazines. Symptom relief can be reached in 90% of the patients with a differentiated approach.
恶心和呕吐是晚期恶性疾病患者最令人苦恼的胃肠道症状。胃肠道与脑干之间存在复杂的病理生理机制。神经递质起重要作用。选择止吐药时,详细的病史和体格检查是必要的。根据病因,将选择外周或中枢阻断受体的止吐药。主要的止吐药类别有促动力药、5-羟色胺3拮抗剂、多巴胺拮抗剂、抗组胺药和吩噻嗪类。采用个体化方法,90%的患者症状可得到缓解。