Dept of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.
Dept of Critical Care Medicine, Respiratory Institute and Section of Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
Eur Respir Rev. 2018 Dec 19;27(150). doi: 10.1183/16000617.0069-2018. Print 2018 Dec 31.
Pulmonary arterial hypertension (PAH) is a condition characterised by increased pulmonary vascular resistance which can lead to right heart failure and premature death. It imposes a significant burden on patients' lives, affecting their physical, emotional and social wellbeing. Pharmacological therapies are the mainstay of treatment; while they are not curative, they can alleviate patient suffering, improve quality of life and delay disease progression. Despite these therapies, disease progresses in a significant number of patients, who are faced with the debilitating symptoms of PAH and treatment adverse effects. Palliative care is focused on providing relief from symptoms caused by a chronic illness. Palliative care aims to improve the health-related quality of life for patients and families, and although it is deemed appropriate at any stage of disease, it is most helpful when explored early in the course of disease. Importantly, palliative care can be provided in concert with pharmacological treatment. Despite its potential benefits, palliative care is frequently underutilised. There is a paucity of clinical studies testing the impact of palliative care in PAH which prompted us to summarise the available evidence, recognise obstacles in its utilisation and identify areas for future research.
肺动脉高压（PAH）是一种以肺血管阻力增加为特征的疾病，可导致右心衰竭和过早死亡。它给患者的生活带来了巨大的负担，影响了他们的身体、情感和社会福祉。药物治疗是治疗的主要方法；虽然它们不能治愈疾病，但可以减轻患者的痛苦，提高生活质量并延缓疾病进展。尽管有这些治疗方法，仍有相当数量的患者病情进展，他们面临着 PAH 的衰弱症状和治疗不良反应。姑息治疗的重点是缓解由慢性疾病引起的症状。姑息治疗旨在改善患者及其家庭的与健康相关的生活质量，尽管它被认为在疾病的任何阶段都适用，但在疾病早期探索时最有帮助。重要的是，姑息治疗可以与药物治疗同时进行。尽管有潜在的益处，但姑息治疗的应用仍然不足。目前缺乏测试姑息治疗在 PAH 中影响的临床研究，这促使我们总结现有的证据，认识到其应用中的障碍，并确定未来研究的领域。
