患者在呼吸系统支持方面的选择会影响阿片类药物在肌缩性侧面硬化症中的使用
Chiharu Matsuda1, Yuki Nakayama1, Michiko Haraguchi1
1Unit for Intractable Disease Nursing Care, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan and.
Amyotrophic lateral sclerosis & frontotemporal degeneration
|January 24, 2025
概括
呼吸系统支持影响了阿片类药物在肌缩侧面硬化症 (ALS) 中的使用. 没有使用气管切除术和侵入性通风 (TIV) 的患者比使用过的患者更经常需要阿片类药物.
科学领域:
- 神经学 神经学
- 肺部病理学 肺部病理学
- 抚慰性护理是一种缓解性护理.
背景情况:
- 肌缩侧面硬化症 (ALS) 给呼吸系统带来了重大挑战.
- 类阿片类止痛药经常用于ALS的症状管理.
- 在ALS患者中,呼吸器支持策略的差异很大.
研究的目的:
- 研究不同呼吸系统支持方法与ALS患者的阿片类药物使用之间的关系.
- 为了确定呼吸辅助的类型是否会影响对阿片类药物缓解疼痛的需求.
主要方法:
- 对399名ALS患者的回顾性审查.
- 根据呼吸器支持,分为四组:没有呼吸器,仅进行非侵入性通风 (NIV),NIV到气管切除和侵入性通风 (TIV),仅进行TIV.
- 多变量后勤分析以评估阿片类药物使用率.
主要成果:
- 32.6%的患者使用阿片类药物.
- 只有NIV组的阿片类药物使用率最高 (57.5%),只有TIV组的阿片类药物使用率最低 (1.7%).
- 仅使用NIV与阿片类药物的使用增加有关,而过渡到或使用TIV与阿片类药物的使用减少有关.
结论:
- 呼吸系统支持的选择显著影响ALS的阿片类药物使用.
- 避免TIV的患者更有可能需要阿片类药物来治疗症状.
- 在ALS患者中,TIV可能会减少对阿片类止痛药的需求.
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