药理学策略,为患者提供狂妄缓解终端呼吸障碍:二次数据分析
Takaaki Hasegawa1, Masanori Mori2, Takashi Yamaguchi3
1Center for Psycho-Oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan.
Cancer medicine
|February 11, 2025
概括
晚期癌症患者的呼吸不良和妄想经常导致难治性痛苦. 药物干预措施,如阿片类药物和抗精神病药物,在改善这些症状方面表现出有限的有效性.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 在瘤学瘤学.
- 老年病的医生 老年病的医生
背景情况:
- 系统性阿片类药物和抗精神病药物分别是呼吸障碍和痴呆症的标准治疗方法.
- 对于患有呼吸障碍和痴呆症的患者来说,最佳的息药理学策略仍然不清楚.
- 这项研究调查了晚期癌症患者的症状轨迹和治疗反应,这些患者同时出现呼吸障碍和妄想.
研究的目的:
- 为了探索晚期癌症患者呼吸障碍和妄想的症状过程.
- 评估药理干预措施的有效性,包括阿片类药物和抗精神病药物,对这些症状.
- 确定在终身护理中管理耐药症状的挑战.
主要方法:
- 一个多中心前性观察研究的二次分析.
- 将成人晚期癌症患者纳入日本息护理单位,患有呼吸障碍 (综合息护理结果表 (IPOS) 评分≥2) 和痴呆症.
- 评估药理策略,呼吸障碍IPOS分数和妄想症状 (纪念妄想评估尺度第9项).
主要成果:
- 分析了141名患者,58%患有激动性妄想,平均存活时间为4天.
- 22%的人接受了阿片类药物启动/升级,65%的人使用常规抗精神病药物.
- 呼吸障碍IPOS分数从第1天到第2天显著下降,但只有21%的患者有反应. 到第二天,激动狂妄症组的74%的人仍然保持着兴奋.
结论:
- 在生命的最后几天,呼吸障碍和妄想的结合代表了难治性痛苦的重要来源.
- 目前的药理干预措施,包括阿片类药物和抗精神病药物,在管理这些复杂的并发症状方面表现出有限的有效性.
- 需要进行进一步的研究,以开发更有效的缓解护理策略,治疗耐火性呼吸障碍和妄想症患者.
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