中国癌痛控制战略的实施现状与展望

Present Implementation Situation and Prospects of Cancer Pain Control Strategy in China

简介我国癌症疼痛控制战略的实施现状及其可能的发展前景。我国自1990年推广实施WHO癌症疼痛三阶梯治疗方案,癌痛治疗状况虽发生一些改善,但是受益的癌症疼痛患者所占比例并不高。WHO认为一个国家的吗啡消耗量是评价该国癌痛改善状况的一个重要指标。中国的吗啡消耗量仍特别低,为了达到“让中国癌症患者不痛”的目标,非常需要做好以下诸项工作:更新用麻醉药观念,消除阿片类药物“成瘾恐惧”的心理束缚;改变不合理的处方习惯,认知哌替啶不适于为癌症患者缓解慢性疼痛;麻醉药品管理要保证医疗需求;大力开展医务人员培训工作,加大宣传力度,进一步推广规范三阶梯治疗原则;在应用镇痛效果好、副作用少的新药的同时,要改善对廉价即释吗啡片的供应。控制癌痛是医生的神圣职责,需要做出不懈的努力。

Synopsizing the present implementation situation of cancer pain control strategy in China and its possible developing prospect. Since 1990, the cancer pain three-step analgesic ladder recommended by WHO was popularized in China, although some improvement in cancer pain treatment has occurred, yet there is no large proportion of cancer patients who have been benefited in cancer pain. The WHO considered a country' s mor-ohine consumption to be one important indicator of progress to improve cancer pain management in a country, and the morphine consumption in China is particularly low.In order to achieve an objective'let Chinese cancer ratients suffer no pain' , it is very necessary to have the following works being well done: Renewal of idea of us-ug narcotic drugs, relief of the trammels of psychology of 'addiction phobia' ; improvement of not rational custom of prescription, understanding of that pethidine should be avoided in chronic cancer pain patient; the regulation of narcotic drugs must guarantee the medical requirement; carrying out vigorously the training of medical professconals, carrying on active propaganda and further popularization of the standard WHO three-step cancer pain relief program; necessary improvement of the supply of low-priced immediate-release morphine tablets for clinical use, although there are new analgesics being used with good result and little side-effect. Cancer pain control is sacred duty of doctors, who should make unremitting efforts.