癌症终末期呼吸困难管理中的未解决问题和未来方向。
Unanswered questions and future direction in the management of terminal breathlessness in patients with cancer.
机构信息
Palliative Care Team, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan.
Division of Palliative Care, Konan Medical Center, Kobe, Japan.
出版信息
ESMO Open. 2020;5 Suppl 1(Suppl 1):e000603. doi: 10.1136/esmoopen-2019-000603. Epub 2020 Sep 30.
Abstract
Breathlessness is among the most common and deteriorating symptoms in patients with advanced cancer, which may worsen towards the end of life. Breathlessness in patients with estimated life expectancy of weeks to days has unique clinical features: it tends to worsen rapidly over days to hours as death approaches often despite current symptom control measures. Breathlessness in patients during the last weeks to days of life can be called 'terminal breathlessness'. While evidence has accumulated for the management of breathlessness in patients with cancer who are not dying, such evidence may not be fully applied to terminal breathlessness. Only a few studies have investigated the best practice of terminal breathlessness in patients with cancer. In this paper, we summarise the current evidence for the management of terminal breathlessness, and propose future directions of clinical research.
摘要
呼吸困难是晚期癌症患者最常见和恶化的症状之一，在生命末期可能会恶化。预计生命预期为数周到数天的患者的呼吸困难具有独特的临床特征：尽管目前有症状控制措施，但在接近死亡时，呼吸困难往往会在数天到数小时内迅速恶化。生命的最后几周到几天的患者的呼吸困难可以称为“终末期呼吸困难”。虽然已经积累了大量关于非临终癌症患者呼吸困难管理的证据，但这些证据可能无法完全应用于终末期呼吸困难。只有少数研究调查了癌症患者终末期呼吸困难的最佳实践。在本文中，我们总结了终末期呼吸困难管理的现有证据，并提出了临床研究的未来方向。
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