Currow David C, Ward Alicia M, Abernethy Amy P
Flinders University, Daw Park, SA, Australia.
Curr Opin Support Palliat Care. 2009 Jun;3(2):103-6. doi: 10.1097/SPC.0b013e32832b37fa.
To explore advances in the pharmacological treatment of refractory breathlessness and the physiological evidence for treatments.
The evidence for the role of oral and parenteral opioids in the reduction of breathlessness continues to strengthen from individual studies and from systematic reviews. Importantly, more data are emerging about a lack of lowering in oxygenation or carbon dioxide retention with opioid therapy. In healthy volunteers and those with refractory dyspnoea, nebulized frusemide appears to be worthy of further investigation with adequately powered phase III studies.
Opioids prescribed regularly can help to predictably and safely reduce breathlessness for people with a range of end-stage illnesses.
探讨难治性呼吸困难药物治疗的进展及治疗的生理学依据。
个体研究和系统评价不断强化口服及胃肠外阿片类药物在减轻呼吸困难方面作用的证据。重要的是，越来越多的数据表明阿片类药物治疗不会降低氧合或导致二氧化碳潴留。在健康志愿者和难治性呼吸困难患者中，雾化使用速尿似乎值得通过有足够样本量的III期研究作进一步调查。
规律使用阿片类药物有助于可预测且安全地减轻一系列终末期疾病患者的呼吸困难。
