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[老年疼痛]

[Pain in old age].

作者信息

Cegla Thomas Hubert, Horlemann Johannes

机构信息

Helios Universitätsklinikum Wuppertal - Schmerzklinik, Im Saalscheid 5, 42369, Wuppertal, Deutschland.

出版信息

Z Gerontol Geriatr. 2018 Dec;51(8):865-870. doi: 10.1007/s00391-018-01477-0. Epub 2018 Nov 19.

Abstract

The prevalence of chronic pain increases with increasing age. Multimorbidity increases the risk of disease-related pain. Addressing the problem of pain in higher age is concerned with an increasing problem of care. The multimorbidity and the resulting multimedication are important for the medical care of pain. The therefore necessary physician-patient verbal communication can hardly be remunerated and carried out in the current care landscape. Existing resources must be bundled. The quality of life of older people and not the absence of pain, must be emphasized. Particularly problematic is the recognition and treatment of pain in patients with dementia. Pain in dementia patients is more rarely detected. In addition to questioning relatives and caregivers, a structured pain interview is necessary. The pharmacology of chronic pain is concerned above all with the prevention of iatrogenic risks through interactions and pharmacological complications. The patient-related treatment priorities must be checked and adjusted during the course of treatment. To be considered are age-related altered metabolic pathways. A sensible therapy option is the training of physical activity with a positive effect on the entire pain experience. Behavioral medical treatment procedures are other important building blocks in pain therapy. In addition to the multimodal therapeutic approaches, a stronger interdisciplinary collaboration of special pain medicine and geriatrics is necessary.

摘要

慢性疼痛的患病率随年龄增长而增加。多种疾病并存会增加与疾病相关疼痛的风险。解决老年人的疼痛问题关乎日益严峻的护理问题。多种疾病并存以及由此产生的多种药物治疗对疼痛的医疗护理很重要。因此,在当前的护理环境下,必要的医患口头沟通很难得到报酬并实施。必须整合现有资源。必须强调老年人的生活质量而非无疼痛状态。痴呆患者疼痛的识别和治疗尤其成问题。痴呆患者的疼痛更难被察觉。除了询问亲属和护理人员外,还需要进行结构化的疼痛访谈。慢性疼痛药理学首先关注通过相互作用和药物并发症预防医源性风险。在治疗过程中必须检查并调整与患者相关的治疗优先级。需要考虑与年龄相关的代谢途径改变。明智的治疗选择是进行体育活动训练,这对整个疼痛体验有积极影响。行为医学治疗程序是疼痛治疗中的其他重要组成部分。除了多模式治疗方法外,特殊疼痛医学和老年医学之间加强跨学科合作也很有必要。

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