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慢性癌痛规范化处理中的药物治疗(上)
晚期恶性肿瘤是一类慢性消耗性疾病,随着肿瘤的不断进展,全身症状逐渐恶化,临床会出现代谢性障碍,营养缺乏等恶液质表现,其中慢性癌痛是患者为痛苦,也是使其生活质量下降的重要因素.慢性癌痛的治疗逐渐成为肿瘤患者治疗过程中的主要目标之一,姑息护理也逐渐成为一项重要的医学护理专业.
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慢性癌痛规范化处理中的药物治疗(下)
癌痛的缓解不是一劳永逸的,大部分病人的疼痛可以被很好地控制,但当疾病进展时,先前的疼痛又可出现,或产生新的疼痛.还有些疼痛会在活动或负重时突然加剧.有效的疼痛治疗为综合治疗,常用治疗癌痛的方法有心理治疗、躯体治疗和药物治疗,其中药物治疗是癌痛治疗的主要方法.
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放射治疗癌性骨转移疼痛的临床体会
骨是肿瘤转移的常见部位,引起的疼痛等症状已成为肿瘤患者的大痛苦,局部放疗是治疗骨转移癌的有效方法.快速止痛、有效控制和减少骨相关事件的发生有着重要的临床意义.
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癌痛的影响因素和护理干预
疼痛在癌症患者中极为常见.在我国,现有癌症患者200多万,这些患者40%~50%发生癌性疼痛,其中25%的患者末得到治疗,63.4%的患者治疗不充分[1].每年全世界接受抗癌治疗的成人和儿童中50%有疼痛;在癌痛的患者中50%为中度疼痛,30%为重度疼痛,晚期癌症患者中70%有疼痛[2].
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麻醉镇痛药品在癌痛治疗中的管理和使用
麻醉药品是指具有依赖性潜力,不合理使用或者滥用可以产生身体依赖性和精神依赖性(即成瘾性)的药品、包括天然、半合成、合成的阿片类、可卡因类、大麻类以及国家规定管制的其他药品、药用原植物或者物质.
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多瑞吉治疗癌痛的疗效观察
Objective To evaluate the effectiveness of transdermal fentanyl (Durogesic) in the treatment of cancer pain. Methods 30 cases of patients with moderate to severe cancer pain were treated using Durogesic,and 30 patients were treated using sustained release hydrochloride morphine tablets as control group.Durogesic began from the dosage of 25 μ g/h to individual doses,and hydrochloride morphine began from 30 mg to individual doses.The duration of treating time was 3 weeks.Results The response rate of pain relief was 80.0% in Durogesic group and 83.3% in hydrochloride morphine group,respectively; Quality of life scores were(27.27± 3.53)before treatment and(32.67± 2.88)after treatment(P<0.05) in Durogesic group;The main side effect were dizziness,nausea and somnolence.Conclusion Durogesic is effective in the treatment of cancer pain,it can improve the quality of life scores and the side effect is mild to tolerate.
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多瑞吉治疗癌性疼痛65例疗效分析
Objective To evaluate the effect and toxicological reactions of Duoruifen in the management of cancer Pain. Method Transfer Fentanyl with trade name Duoruifen was applied to control chronically moderate to severe cancer pain in 65 cases. Change of drug was conducted once 72 hours, for 30~ 120 days. Observation indexes included pain intensity, relief rate, life satisfaction, quality of life, etc..Result Relief for moderate and severe cancer pain was 88.63% and 80.95% ,respectively.Alteration intercourse for 21.54% patients was reduced,and satisfaction was 93.84% . Quality of life was markedly improved. Incidence of constipation, vomiting, dizziness and nausea was 13.84% ,10.76% ,7.69% and 7.69% respectively.Conclusion Duoruifen is capable of effectively controlling cancer pain with good acceptability, adverse effect patients willing to accept it.
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癌性神经痛及其发病机制
早期和晚期癌症患者中疼痛的发生率分别高达48%和64%~75%[1-2],严重影响患者的生活质量.在所有的癌性疼痛中,神经病理性疼痛占19.0%~39.1%.尽管癌性神经痛(neuropathic cancer pain,NCP)的病因不同,但均存在神经损伤,导致多个部位结构的改变,并影响脊髓和脑的功能.由于NCP的病理机制复杂,需开展作用于多位点的协同治疗.
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高能聚焦超声辅助低剂量吉西他滨缓解晚期胰腺癌患者疼痛
胰腺癌的疼痛治疗是影响胰腺癌病人生活质量的重要因素.本文回顾性地研究了10位接受高能聚焦超声及低剂量吉西他滨治疗的患者的疼痛缓解情况,发现90%的患者疼痛得到了超过50%的缓解,90%患者治疗后2月内未发生需要治疗的爆发性疼痛.提示高能聚焦超声可能可用于胰腺癌的疼痛治疗.