化脓性梅克尔细胞癌在姑息治疗中的疼痛和伤口处理:关于这一困境的首例报告

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES
Shaan Mohan, Ahmad Khan
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引用次数: 0

摘要

梅克尔细胞癌(MCC)是一种罕见的神经内分泌梅克尔机械感受器皮肤癌。这些细胞与神经末梢密切相关,由于靠近皮肤组织,容易发展成深度溃疡、发霉的恶性肿瘤。这些易碎伤口很容易受到刺激,会给患者带来极大的痛苦。我们报告了一例左侧头皮严重真菌性MCC的姑息治疗病例,患者的主要疾病负担是疼痛。这位90岁的老先生是由组织存活率团队转介到姑息治疗的,他主诉在换药时有阵发性灼痛,并伴有前额放射性疼痛、恶心和严重的特质性焦虑。据推测,这种疼痛可能部分是紧张性头痛引起的,而不仅仅是痛觉,因此医生给他开了氯羟安定来缓解特质焦虑。用药后,所有症状都得到了明显缓解。为了吸收渗出物和平衡湿度,我们使用了一种专业敷料,我们相信这可能会阻止疼痛的进一步恶化。总之,本报告强调了在文献中未发现的病例中考虑痛觉以外的其他疼痛病因的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pain and Wound Management in Fungating Merkel Cell Carcinoma within a Palliative Setting: The First Case Report of this Predicament
Merkel cell carcinoma (MCC) is a rare type of skin cancer of the neuroendocrine Merkel mechanoreceptors. These cells are closely associated with nerve terminals and, given their proximity to cutaneous tissue, have the propensity to develop into deeply ulcerated, fungating malignancies. These friable wounds are easily irritated, and can cause significant pain for patients. We report a palliative case of severe, fungating MCC of the left scalp where the main contributor to the patient’s illness burden is pain. Having been referred to palliative care by the Tissue Viability team, this 90-year-old gentleman was complaining of episodic burning pain during dressing changes, which was associated with radiation to the forehead, nausea, and significant trait anxiety. It was theorised that this pain could be in part due to tension headache, not just nociception, and anticipatory lorazepam was prescribed to relieve trait anxiety. All symptoms were majorly relieved following this administration. A specialist dressing was implemented to absorb exudate and balance moisture, which we believe may have stopped further deterioration of pain. Overall, this report emphasises the need to consider alternative pain aetiologies other than nociception in a presentation that is not found in the literature.
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来源期刊
Indian Journal of Palliative Care
Indian Journal of Palliative Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
2.30
自引率
0.00%
发文量
57
期刊介绍: Welcome to the website of the Indian Journal of Palliative Care. You have free full text access to recent issues of the journal. The links connect you to •guidelines and systematic reviews in palliative care and oncology •a directory of palliative care programmes in India and IAPC membership •Palliative Care Formulary, book reviews and other educational material •guidance on statistical tests and medical writing.
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