Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Cancer Res Treat. 2022 Jul;54(3):661-670. doi: 10.4143/crt.2022.143. Epub 2022 Jun 30.
Patients with advanced cancer are faced with many devastating symptoms in the last weeks and days of life, such as pain, delirium, dyspnea, bronchial hypersecretions (death rattle) and intractable seizures. Symptom management in the last weeks of life can be particularly challenging because of the high prevalence of delirium complicating symptom assessment, high symptom expression secondary to psychosocial and spiritual factors, limited life-expectancy requiring special considerations for prognosis-based decision-making, and distressed caregivers. There is a paucity of research involving patients in the last weeks of life, contributing to substantial variations in clinical practice. In this narrative review, we shall review the existing literature and provide a practical approach to in-patient management of several of the most distressing physical symptoms in the last weeks to days of life.
晚期癌症患者在生命的最后几周和几天面临许多严重的症状，如疼痛、谵妄、呼吸困难、支气管过度分泌（死亡喘息）和难治性癫痫发作。由于谵妄使症状评估变得复杂、心理社会和精神因素导致症状表达增加、预期寿命有限需要特别考虑基于预后的决策以及护理人员痛苦等原因，生命最后几周的症状管理可能特别具有挑战性。涉及生命最后几周患者的研究很少，导致临床实践存在很大差异。在这篇叙述性综述中，我们将回顾现有文献，并提供一种实用的方法来管理生命最后几周至几天内几种最痛苦的身体症状。
