优化阿片类药物在癌痛管理中的应用。
Optimizing use of opiates in the management of cancer pain.
出版信息
Ther Clin Risk Manag. 2006 Dec;2(4):447-53. doi: 10.2147/tcrm.2006.2.4.447.
Abstract
Cancer pain is often suboptimally managed. The underestimation and undertreatment continues to be a problem despite the availability of consensus-based guidelines. Most patients with cancer develop pain. The prevalence and severity of pain among cancer patients varies according to primary and metastatic sites and stage of disease. Opioid therapy is the cornerstone of management of severe chronic pain in the field of cancer patients and in general in palliative care medicine. Since this class of drugs is the cornerstone of the treatment, optimizing its use may be useful in clinical practice. For this purpose we focused on 4 distinct issues: 1) How to implement the use the opioids in cancer patients; 2) How to optimise the use of morphine in cancer patients; 3) The management of side effects and opioid switching; 4) What is the role of other potent opioids. A holistic approach including an appropriate use of opioids may improve pain control in most cancer patients, particularly for those with advanced disease.
摘要
癌症疼痛常常得不到充分控制。尽管有基于共识的指南，但这种低估和治疗不足的情况仍然存在。大多数癌症患者会出现疼痛。癌症患者的疼痛发生率和严重程度因原发和转移部位以及疾病分期而异。阿片类药物治疗是癌症患者严重慢性疼痛管理领域以及一般姑息治疗医学的基石。由于这类药物是治疗的基石，因此优化其使用可能对临床实践有用。为此，我们重点关注了 4 个不同的问题：1）如何在癌症患者中实施阿片类药物的使用；2）如何优化癌症患者中吗啡的使用；3）副作用的管理和阿片类药物的转换；4）其他强效阿片类药物的作用是什么。包括适当使用阿片类药物在内的整体方法可能会改善大多数癌症患者的疼痛控制，尤其是那些晚期疾病患者。
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