药理学策略缓解终端狂妄症患者的疼痛: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.
Palliative medicine reports
|December 4, 2025
概括
在患有痴呆症的末期癌症患者中使用阿片类药物和抗精神病药物并没有完全消除症状. 持续的癌症疼痛和激动性妄想是常见的,突出显示了生命末期症状管理的复杂性.
科学领域:
- 抚慰性护理医学 抚慰性护理医学
- 在瘤学瘤学.
- 老年病的医生 老年病的医生
背景情况:
- 绝症癌症患者经常经历疼痛和妄想.
- 通常用于治疗疼痛的阿片类药物可能会恶化妄想,使护理复杂化.
- 管理这些同时出现的症状是一个重大的临床挑战.
研究的目的:
- 为了研究癌症疼痛和妄想的现实世界症状轨迹.
- 分析与阿片类药物和抗精神病药物等药理干预措施的关联.
- 了解癌症患者生命的最后几天的症状管理.
主要方法:
- 一个多中心前性观察研究的二次分析.
- 包括日本住院息治疗单位的成年患者,患有癌症疼痛和妄想.
- 使用综合息护理结果表 (IPOS) 评估疼痛,使用纪念狂妄症评估表评估狂妄症.
主要成果:
- 在137名分析患者中,86人患有激动性妄想;中位生存时间为3天.
- 在23%的患者中出现了阿片类药物启动/升级,而在69%的患者中使用了抗精神病药物.
- 在第二天,持续的癌症疼痛影响了55%,激动性妄想影响了79%.
结论:
- 最终阶段的癌症疼痛和妄想是复杂的,难以管理的.
- 目前的药理学策略在解决这些症状方面表现出有限的有效性.
- 需要进一步的研究来改善这些患者的息护理.
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