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[肿瘤学中的疼痛问题]

[Pain problems in oncology].

作者信息

Senn H J

机构信息

Medizinische Klinik C, Kantonsspital St. Gallen.

出版信息

Schweiz Med Wochenschr. 1990 Aug 7;120(31-32):1135-42.

PMID:2392663
Abstract
  1. Not every cancer patient suffers from pain, but approximately 30-40% of regular inpatients and 60-70% in terminal stages do. 2. Not every pain syndrome in a cancer patient is tumor-derived: its role and potential cause need to be thoroughly investigated and treated. 3. Successful antineoplastic treatment is the best and most durable pain prophylaxis in advanced cancer patients. 4. Locally applicable pain treatments such as anesthesiologic, radiotherapeutic and surgical measures should be discussed on an interdisciplinary basis. 5. With chronic tumor pain and no further effect of antineoplastic and locally active treatments, pharmacologic analgesia is the most adequate method of effective pain relief. 6. Prophylactic prescription of effective analgesics in adequate doses and at regular intervals, according to accepted "pain-ladders", is the most successful method of effective and lasting pain relief. 7. Public and medical bias against adequate use of oral opiates in chronic cancer pain must be overcome. 8. Effective pain relief leads to improvement of life quality as well as social reintegration of late stage cancer patients. 9. The influence of psychosocial variables on pain perception and the outcome of analgesia should not be underestimated.
摘要
  1. 并非每个癌症患者都遭受疼痛,但约30 - 40%的普通住院患者以及60 - 70%的晚期患者会疼痛。2. 癌症患者的疼痛综合征并非都源于肿瘤:其作用及潜在病因需进行全面调查和治疗。3. 成功的抗肿瘤治疗是晚期癌症患者最佳且最持久的疼痛预防措施。4. 应在多学科基础上讨论局部适用的疼痛治疗方法,如麻醉、放疗和手术措施。5. 对于慢性肿瘤疼痛且抗肿瘤及局部有效治疗均无进一步效果时,药物镇痛是有效缓解疼痛的最适当方法。6. 根据公认的“疼痛阶梯”,定期给予足够剂量的有效镇痛药进行预防性处方,是有效且持久缓解疼痛的最成功方法。7. 必须克服公众和医学界对在慢性癌症疼痛中充分使用口服阿片类药物的偏见。8. 有效的疼痛缓解可改善晚期癌症患者的生活质量并使其重新融入社会。9. 不应低估社会心理变量对疼痛感知及镇痛效果的影响。

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