世卫组织指导方针:新的和旧的
1Supportive & Palliative Care, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, UK.
Current opinion in supportive and palliative care
|September 9, 2024
概括
更新的世界卫生组织 (WHO) 癌症疼痛指南 (2018) 提供了改进的,基于证据的建议. 世界卫生组织最初的止痛梯不再被推作为管理癌症疼痛的严格协议.
科学领域:
- 在瘤学瘤学.
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 世界卫生组织 (WHO) 在1986年首次发布了癌症疼痛指南.
- 这些指导方针已经在全球范围内被采用和使用了几十年.
- 世卫组织癌症疼痛指南的更新版本于2018年发布.
研究的目的:
- 为了比较原始的1986年世卫组织癌症疼痛指南与更新的2018年指南.
- 评估世卫组织镇痛药梯在当代临床实践中的持续相关性和应用.
- 确定癌症疼痛管理策略的关键进展和变化.
主要方法:
- 1986年和2018年世卫组织癌症疼痛指南的比较分析.
- 文献综述侧重于癌症疼痛管理的基于证据的建议.
- 对世卫组织止痛药阶梯的有效性和局限性的批判性评估.
主要成果:
- 2018年的指导方针更加基于证据,包括放射治疗管理建议.
- 加强对安全阿片类药物处方,阿片类药物管理和早期整合疼痛管理专业知识的关注.
- 对于某些广泛使用的疗法,特别是辅助剂,仍然缺乏证据.
- 突出了原来的世卫组织止痛梯的局限性,有证据支持将"第二步"作为安全和成本效益的省略.
结论:
- 更新的世卫组织指南提供了更详细,临床相关的建议,强调了阿片类药物处方安全性.
- 世界卫生组织最初的止痛梯不再被认为是癌症疼痛管理的严格协议.
- 当代的癌症疼痛管理需要一种更加细致和基于证据的方法.
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