安宁疗护中的镇痛管理

Analgesic management in hospice care

疼痛是恶性肿瘤和非恶性肿瘤疾病终末期最常见的症状之一,也是患者最恐惧的症状,严重影响生命末期的生存质量。安宁疗护为疾病终末期的患者及家属提供身体、心理、精神等方面的照护,减轻患者的痛苦和不适症状,疼痛管理作为重要的症状管理内容之一,是安宁疗护的基石。随着我国肿瘤和慢性疾病发病率的升高以及人口老龄化的加速,患严重疾病的老年人数量快速增加,疼痛控制需求迅速增长。对安宁疗护患者开展镇痛管理,需要对疼痛进行全面的评估以明确其类型及特点,运用病因治疗、药物治疗、介入治疗、物理治疗、心理治疗及舒适照护等方法开展多模式管理,科学使用阿片类药物,减少药物不良反应,达到最佳的疼痛控制,提高患者生命末期的生活质量。

Pain is a prevalent symptom in both cancer and non-cancer end-stage diseases,often being the most feared by patients and significantly impacting their quality of life.Hospice care aims to address physical,psychological,spiritual,and other needs of patients and their families during this stage,with a focus on alleviating pain and discomfort.Effective pain management is a crucial component of hospice care,particularly given the increasing prevalence of cancer and chronic diseases in China and the growing elderly population.To provide analgesic management for hospice patients,a thorough assessment of pain is essential to identify its type and characteristics.Treatment approaches may include etiological interventions,pharmacotherapy,interventional therapy,physiotherapy,psychotherapy,and comfort care,all aimed at achieving comprehensive pain management.The use of opioid should be carefully guided by scientific principles to minimize adverse effects and optimize pain relief,ultimately enhancing patients'end-of-life quality of life.