Hematology Unit, S. Eugenio Hospital, Rome, Italy.
Expert Rev Hematol. 2011 Feb;4(1):81-93. doi: 10.1586/ehm.10.79.
Pain is frequently experienced by patients with hematological malignancies, although it often receives little attention. Different underlying causes and mechanisms may sustain several pain syndromes in hematological malignant patients. Pain may be due to disease itself, to disease-related complications, to iatrogenic causes or may be associated with unrelated medical conditions. The management of pain in this setting requires a multidisciplinary approach, integrating analgesics and causal interventions. An accurate diagnostic assessment and the identification of the underlying causes and pathogenetic mechanisms may dictate the treatment approach. For most pain patients, the WHO's three-step analgesic scale for cancer pain relief can provide adequate relief with oral options, although difficult-to-treat pain syndromes, requiring a more complex treatment approach, may also be observed.
血液病患者常经历疼痛，但通常未受到重视。不同的潜在病因和机制可能导致血液病患者出现多种疼痛综合征。疼痛可能源于疾病本身、疾病相关并发症、医源性原因，也可能与无关的医疗状况相关。此类情况下的疼痛管理需要多学科方法，整合镇痛药物和病因干预。准确的诊断评估以及潜在病因和发病机制的识别可能决定治疗方法。对于大多数疼痛患者，世界卫生组织（WHO）的癌症三阶梯止痛治疗方案中的口服药物可提供充分的缓解，但也可能观察到难以治疗的疼痛综合征，需要更复杂的治疗方法。
