痛及镇痛定义及基础理论知识.pptVIP

痛和镇痛定义和基础理论知识 Pain and Pain Relief 王韵 痛和镇痛定义和基础理论知识 概述 痛觉 痛觉调制 疼痛的治疗 痛和镇痛 Pain and Pain Relief 王韵 痛和镇痛定义和基础理论知识 概述 Introduction 疼痛的概念 Concepts of pain IASP: pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage 疼痛是与现实的或可能的组织损伤有关的一种不愉快的感觉性和情绪性体验 包括痛感觉和痛反应 伤害性感受（nociception）和痛觉（pain） 是人类对疼痛的感觉，是人类所特有的 王韵 痛和镇痛定义和基础理论知识 概述 Introduction 痛觉：发生在躯体某一部分的厌恶和不愿忍受的感觉，属于知觉范畴，发生在脑的高级部位，尤其是大脑皮层，是人独有的 伤害性感受：CNS对伤害性感受器激活而引起的传入信息的反应和加工，以提取组织损伤的信息，它可以发生在CNS的各个水平，从低等动物到人均有 两者之间有时并没有严格的相关性 由于痛觉是意识水平的感觉，我们无法确定动物是否具有痛觉，只能观察其对伤害性刺激的行为反应。因而在描述动物时伤害性感受取代疼痛 王韵 痛和镇痛定义和基础理论知识 Pain Reaction:是伤害性刺激所产生的躯体和内脏反应，往往与自主神经活动、运动反射、心理和情绪反应交织在一起，从人到低等动物都有。 Local reaction：受到伤害性刺激的局部出现血管扩张，组织水肿 Systemic reaction：在中枢神经系统参与下，机体对伤害性刺激做出的有规律的应答 Behavior reaction：在高级脑部参与下，机体对伤害性刺激做出的躲避、反抗、攻击等整体行为，带有强烈的情绪色彩 王韵 痛和镇痛定义和基础理论知识 痛觉的特性 复合感觉 复杂的心理活动 具有“经验”的属性 Complex perception Experience Complicated psychology 痛觉的意义及危害 王韵 痛和镇痛定义和基础理论知识 American people spend 1/3 of total medical budget for pain relieving One in three Australian households has one or more members in chronic pain Of them 45% complaining severe to unendurable pain that has been present for more than 3 years How do we really percept pain from the brain remains unknown 王韵 痛和镇痛定义和基础理论知识 Cancer Associated Pain As advances in cancer detection and therapy are extending the life expectancy of cancer patients, there is an increasing focus on improving patients’ quality of life Pain is the first sign of cancer of many patients, 30-50% of all cancer patients will experience moderate to severe pain Cancer can cause pain at any time during the course of the disease, but the frequency and intensity of pain tend to increase during the advanced stages 75-95% of patients with metastatic or advanced-stage, cancer will experience significant amounts of cancer induced pain The curren