癌症患者疼痛的诊断和治疗管理:波兰姑息治疗协会、波兰疼痛研究协会和波兰临床肿瘤协会专家组的建议

IF 0.3 Q4 ONCOLOGY
Wojciech Leppert, Jerzy Wordliczek, Małgorzata Malec-Milewska, Mahdalena Kocot-Kępska, Jarosław Woroń, Renata Zajączkowska, Jan Dobrogowski, Maciej Krzakowski, Małgorzata Krajnik
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引用次数: 0

摘要

为了详细阐述癌症患者疼痛管理的诊断和治疗建议,我们对PubMed和Cochrane数据库2000-2022年期间的文献进行了叙述性回顾。任命由波兰姑息治疗协会、波兰疼痛研究协会和波兰临床肿瘤协会三个科学协会组成的专家组,对文献进行综述,制定具有建议力度和证据质量的指南。为了达到最佳的疼痛治疗效果,癌症患者需要对疼痛进行复杂的临床评估,详细了解疼痛的病理生理、强度和时间框架(基线和突破-发作)。疼痛评估应包括其他症状、合并症、心理、社会和精神方面的干扰,这些可能导致患者的痛苦和疼痛的外观。局部和全身的抗癌治疗可能会诱发或加重癌症或合并症引起的疼痛。癌症和其他疾病过程中慢性疼痛患者的标准方法是基于世界卫生组织(WHO)镇痛阶梯算法,并辅以非药物管理。建议根据具体患者的临床情况采取个体化的疼痛治疗方法。应该努力有效地控制伴随癌症的其他症状。考虑到给定的病理生理、时间框架和疼痛强度的特定治疗方法的引入提高了有效性,显著缩短了实现有效镇痛所需的时间,而且有助于减少使用镇痛药的不良反应的强度和频率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic and therapeutic management of cancer patients with pain: recommendations of the Expert Group of the Polish Association for Palliative Care, Polish Association for the Study of Pain, and Polish Association of Clinical Oncology
In order to elaborate diagnostic and therapeutic recommendations regarding the management of cancer patients with pain, a narrative review of the literature in PubMed and Cochrane database was conducted for the period of 2000–2022. An Expert Group of three scientific associations: Polish Association of Palliative Care, Polish Association for the Study of Pain, and Polish Association of Clinical Oncology was appointed, which made a literature review and formulated guidelines with strength of recommendations and quality of evidence. To achieve optimal effect of pain treatment cancer patients require complex clinical assessment of pain with detailed recognition of pathophysiology, intensity and time frame (baseline and breakthrough — episodic) of pain. Pain evaluation should encompass other symptoms, comorbidities, disturbances in psychological, social, and spiritual dimensions, which may induce patients’ suffering and total pain appearance. An important role plays anticancer local and systemic treatment, which may induce or exacerbate pain induced by cancer or comorbidities. A standard approach in patients with chronic pain in the course of cancer and other diseases is based on World Health Organization (WHO) analgesic ladder algorithm, which is supplemented with non-pharmacological management. It is recommended an individual approach in pain treatment depending on clinical situation of a concrete patient. Efforts should be made to effectively manage other symptoms, which accompany cancer. An introduction of specific treatment taking into account given pathophysiology, time frame and intensity of pain increase effectiveness and significantly shorten time necessary to achieve effective analgesia, and moreover contribute to decrease intensity and frequency of adverse effects of analgesics used.
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来源期刊
CiteScore
0.90
自引率
20.00%
发文量
46
审稿时长
15 weeks
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