Wang Ambulatory Care Center, Suite 835, 15 Parkman Street, Boston, MA 02114, USA; Department of Neurology, Massachusetts General Hospital, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Wang Ambulatory Care Center, Suite 835, 15 Parkman Street, Boston, MA 02114, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Division of Palliative Care, Massachusetts General Hospital, Boston, MA, USA.
Phys Med Rehabil Clin N Am. 2021 Aug;32(3):569-579. doi: 10.1016/j.pmr.2021.02.008. Epub 2021 May 26.
Palliative care is a team-based approach focusing on relief of physical, psychosocial, and existential distress and communication about serious illness. Patients with poliomyelitis and postpolio syndrome are at risk for contractures and can benefit from involvement of physical and occupational therapy. Hypersialorrhea can be treated with anticholinergic medications, botox, or radiation. Patients with dyspnea may require noninvasive positive pressure ventilation ± opioids or benzodiazepines. Constipation is often due to autonomic dysfunction and decreased mobility. There is a higher burden of anxiety. Early conversations about patients' goals and values as it relates to their health may help frame future decision-making.
姑息治疗是一种以团队为基础的方法，侧重于缓解身体、心理社会和存在的痛苦以及对严重疾病的沟通。患有脊髓灰质炎和脊髓灰质炎后综合征的患者有发生挛缩的风险，可以从物理治疗和职业治疗中受益。唾液分泌过多可以用抗胆碱能药物、肉毒杆菌毒素或放射治疗。呼吸困难的患者可能需要无创正压通气±阿片类药物或苯二氮䓬类药物。便秘通常是由于自主神经功能障碍和活动减少引起的。焦虑的负担更高。早期讨论患者的目标和价值观与其健康的关系可能有助于为未来的决策提供框架。
