Simon S T, Müller-Busch C, Bausewein C
Zentrum für Palliativmedizin, Universität Köln, Köln.
Internist (Berl). 2011 Jan;52(1):28, 30-5. doi: 10.1007/s00108-010-2692-4.
Pain and breathlessness are common symptoms in advanced disease. Pain should be treated with a combination of non-opioids and opioids. Coanalgesics play an important role in the treatment of neuropathic pain. Side-effects of opioids should be treated prophylactically but can make opioid rotation necessary. Management of breathlessness needs a combination of non-pharmacological and pharmacological measures. Fans and rollators showed to be effective in relieving breathlessness. Opioids are the drugs of choice for breathlessness. The efficacy of benzodiazepines could not be confirmed, they should only be used as second line therapy. Also, oxygen should only be given regularly after an individual test.
疼痛和呼吸困难是晚期疾病的常见症状。疼痛应采用非阿片类药物和阿片类药物联合治疗。辅助镇痛药在神经性疼痛的治疗中发挥重要作用。阿片类药物的副作用应进行预防性治疗，但可能需要进行阿片类药物轮换。呼吸困难的管理需要非药物和药物措施相结合。风扇和助行器被证明对缓解呼吸困难有效。阿片类药物是治疗呼吸困难的首选药物。苯二氮䓬类药物的疗效尚未得到证实，仅应作为二线治疗使用。此外，只有在个体测试后才应定期给予氧气。
