肿瘤内科的疼痛管理.ppt

管理上较为严格，有需要的病人不能合理或及时的得到相应的符合标准的处理。 1.由于国家政策的限制，现行的麻醉药品管理较为严格。 2.表现为： 1.病人用药量有限制 2.针剂控制 3.药品品种不全，剂量不全 4.地域差异明显 5.处方医生限制 肿瘤内科的疼痛管理现状和对策 癌症相关疼痛的全球性 Cancer-related pain is a major issue of healthcare systems worldwide. The reported incidence, considering all stages of the disease, is 51%, which can increase to 90% in the advanced and terminal stages. For advanced cancer, pain is moderate to severe in about 40–50% and very severe or excruciating in 25–30% of cases. 疼痛治疗的现状在欧洲 A recent European study that focused on the prevalence and treatment of cancer pain has been performed in 11 European countries and Israel in 2006–2007. A total of 5,084 cancer patients were contacted and 56% (573) of them suffered moderate to severe pain at least monthly. The results of this survey challenge the belief that cancer pain is usually well managed. The study found that pain was principally managed by medical oncologists (42%, 242/573). Most patients (72%, 415/573) reported that their clinician asked them about their pain either at most consultations (16%, 95/573) or every consultation (55%, 320/573). Only 15% (88/573) of patients reported that their clinician measured their pain using a pain scale (55%, 320/573). Of 441 patients, 437 reported that they used prescription medications to treat pain. Among these, 24% were taking a step III opioid alone, 12% were taking a step II opioid alone, 7% were taking step II and step III opioids, either together or in combination with non-opioid drugs, and 8% received non-opioid analgesics alone. Eventually, pain was described as distressing by 67% of patients, as an intolerable aspect of their cancer by 36%, and 32% reported that the pain was so bad they wanted to die. Breivik H, Cherny N, Collett B, et al. Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol. 2009;26 [Epub ahead of print] **The most recent study of the prevalence and management of cancer pain in Europe and