Böhme K
Zentrale Abteilung für Anaesthesie u. operative Intensivmedizin, Städtische Kliniken Kassel.
Urologe A. 1988 Mar;27(2):70-6.
Pain in cancer patients is shown to arise in different ways, demanding a flexible approach to treatment. The following procedures can be selected from, depending on the origin of the pain. (1) Systemic analgesia with peripheral or central analgesic agents combined with psychotropic preparation; (2) administration of opioids through peridural or intrathecal catheters (for pain responsive to opioids, but side effects considerable); (3) neurolyses, e.g. epigastric tumors, recurrence of rectal carcinoma; (4) cordotomy, e.g. unilateral pain in plexus infiltration; (5) operations (endoprostheses, bridging osteosynthesis in the case of bone metastases with or without fractures); (6) radiotherapy (strontium in the case of multiple bone metastases of some tumors). Other treatment methods, e.g. administration of karsil or cortisone, as adjuvant therapy require further investigation.
癌症患者的疼痛表现为多种形式,这就需要采用灵活的治疗方法。可根据疼痛的起源从以下方法中选择。(1) 用外周或中枢镇痛药联合精神药物进行全身镇痛;(2) 通过硬膜外或鞘内导管给予阿片类药物(用于对阿片类药物有反应但副作用较大的疼痛);(3) 神经溶解术,如治疗上腹部肿瘤、直肠癌复发;(4) 脊髓切断术,如治疗神经丛浸润引起的单侧疼痛;(5) 手术(植入假体,对于有或无骨折的骨转移采用桥接骨固定术);(6) 放射治疗(某些肿瘤发生多发性骨转移时使用锶)。其他治疗方法,如使用卡西尔或皮质醇作为辅助治疗,还需要进一步研究。