In the cancer patient's subjective symptom, the ache formation rate is highest. The patient's condition patient has 40% to be accompanied by the ache at least. The terminal cancer patient 80% have at least moderate to the specific weight ache. According to the statistical data indicated: Because the world year has 2,500,000 people cancer ache not to be able to obtain the prompt treatment to die. In the world has 3,500,000 people every day, in cancer ache suffers gets by difficultly. The ache not only does not favor the ache the treatment. Also increased the pain to the patient. Reduced patient's survival quality obviously. First, in idea renewal The medical personnel, the patient, the public, the family member to ache understanding, manner, expectation as well as to ache treatment, nursing have had the huge change in the past's more than 30 years. Now, cancer patient's ache question obtained the entire community public figures to take seriously. Takes each kind of remedial measure decisively to cancer ache patient, high method relieves patient's pain, improved patient's survival quality, the extension life new idea has substituted for in cancer ache treatment traditional ideas gradually. But, are many expert to believe at present, the hindrance stops pain effectively the subject matter is not only nurse lacks the understanding to the anaesthetic pharmacological action, moreover, knows the insufficiency to person's life quality and the nursing job category itself. Doctor and nurse worried generally the patient uses the anaesthetic to be able to reappear the spiritual dependence, and the family member also harbors the dread including the patient himself to the anaesthetic. Presents “four does not hope the syndrome”, namely doctor is not willing the sufficiency the pain-killer, the pharmacy not to be willing to send the sufficiency the medicine, nurse/the family member is not willing to give the sufficiency the medicine, the patient is not willing to accept the sufficiency the pain-killer. Therefore not only needs the medical personnel regarding cancer ache's treatment to know that on the renewal, needs the patient and family member's coordination, particularly patient family member's cooperation. Second, family member's function Undeniably, cancer patient many are stays in hospital the treatment in the hospital, but, also had quite a partial cancer patient to pass after all in the home. Therefore, in cancer ache's treatment, the family member is also undertaking the very important responsibility. And includes: 1st, estimates reliably correctly patient's ache, assists the medical personnel to work out the reasonable therapeutic schedule. The patient ache estimates its content including the ache degree, the spot, the nature, the outbreak situation and the complication and so on. Family member when estimate patient's ache, must pay attention to the psychology, the society and the economy besides the bodily factor and so on various factors influence. 2nd, accurate, gives the phial bottle observation pain-relieving medicine promptly the effect and the side effect. 3rd, comforts for the patient, explains and encourages, to enable it to get rid from the spirit to the ache the fear, increases to the life the hope. 4th, the education and the explanation change for the patient to the medicine side effect and the tolerant wrong understanding, encourages the patient to enjoy person's dignity and person's authority. Third, family member's duty In the cancerous ache treatment's process, the role which its family member plays is unwise to underestimate, they need to complete the massive nursing work. Therefore, they must understand and grasp nursing the scope. 1st, understanding cancerous ache treatment basic principle: (1) grasps some effective, the main control ache medicine dosage and the applicable scope truly. (2) the pain-killer heart possibly takes orally, next, is the rectum medication, finally only then chooses the injection. The medicine use should follow from small to big, from few to many principles, and observes the curative effect and the side effect. (3) must the time fixed time apply drugs according to medicine Guan Shuai, must before recently the drug efficacy vanished 1h to apply drugs, exempts increases the pain to the patient, increases the medicine dosage. 2nd, to the patient explained that accepts the treatment the effect, helps the patient to understand the ache produces the reason, takes why the medicine and the taking medicine time does tell the patient to take the medicine as well as the medicine on time has the side effect which and the prevention the possibility produces. 3rd, helps the patient to apply drugs correctly, according to patient's situation, chooses the appropriate medicine and the medication method. When medication, should consider the drug efficacy the duration and patient's habits and customs, avoid as far as possible when the patient rest applies drugs. 4th, the appraisal method of treatment to reduces the ache the effect, reported promptly to doctor, proposed the reasonable suggestion, causes to adjust the therapeutic schedule promptly. 5th, side effect prevention. If the aspirin can stimulate the stomach, the destruction gastric mucosa barrier causes the hemorrhage, and causes the zymoplasm original reduction to cause the whole body hemorrhage tendency and so on. 6th, in the full attention cancerous ache nursing process's integrity stops pain not only includes gives the pharmacological treatment, moreover, must give the patient to create a comfortable environment, helps the patient to obtain a comfortable body posture and so on. Follows frightened which and the anxiety cancer ache comes, the family member needs the related technology, the psychology knowledge helps the patient to overcome these barriers. In brief, the family member facing cancer ache's patient, do not increase the pain to them, or lets them struggle in the pain, but must the corrective method, reduce patient's pain unceasingly. At the same time, but must to doctor, nurse seek for advice unceasingly, seeks for advice to the books, for the patient relieve pain, coordinates doctor, nurse to complete cancer patient's treatment and the nursing survival percentage as far as possible.
According to statistics: The nation cancer new diseased population approximately has every year 1,800,000, 62% are accompanied by the ache. Cancer ache is not only a medicine question, it is a social question. The World Health Organization once in 1982 proposed “in 2000 realized the world non-cancer pain” the specific objectives, we realized this goal possibility in 2000 to have in a big way? The traditional ideas must transform, otherwise the tumor stops pain is very difficult to complete. Certainly this need we the medicine specialists educate the patient, also needs your media the help, disseminates the entire society the correct idea. Some people believed frequently, once cancer patient with the analgetic medicine, means that has sounded the unlucky ding, this idea harm is big. In the real life, many people thought that so long as cancer patient used the analgetic medicine, particularly used the codein, the morphine and so on strong effect analgesic, explained already entered cancer “finally the last stage”. This is one kind of misunderstanding completely. Because receives this kind of misunderstanding the influence, many cancer patients fear so-called “the last stage to approach finally”, then suppresses the ache to suffer, refuses to use the pain-killer; Because or the ache is hard to endure, the patient starts to use the pain-killer, but thought that “the last stage approaches finally”, thus lost continued to treat and the survival confidence. The ache is a cancer patient's common symptom, the ache order of severity and whether to use the strong effect analgesic, with clinical time don't not too big relations. Cancer ache is in the cancer morbidity process ordinary phenomenon, may occur in any time leaves. Although the terminal cancer patient has the ache the proportion to be relatively high, but the early cancer patient may also have cancer ache, even possibly has the fierce ache. Whether cancer patient does have the ache and the pathological change infringement spot concerns. Because for example, a cancer patient the tumor grows in the nerve rich organization, although belongs to the early time, actually possibly has the fierce ache; Another belongs to finally the last stage cancer patient truly, because the pathological change has not implicated the nerve rich organization, possibly does not have the ache symptom. The ache will cause the serious harm, various issue of cancer patients should accept the analgetic treatment. Each clinical time other cancer patients possibly have the ache, but the ache creates to them the harm is similar. Cancer ache not only makes the patient to feel uncomfortable, will also bring a series of serious influences. For example, the disgusting vomit, the anorexia, losing sleep, anxious, frightened, despondent, are not willing with the human to associate; Each physiological function drops, energy drops; Lose the confidence to the life and the treatment and so on. Ache harm which to the body, the physiology and the psychological aspect creates, not only affects obviously patient's quality of life, will also affect the treatment implementation and the effect. Because the partial patients the ache have not been under satisfaction control to lose the patience, will give up permanently curing cancer's opportunity. Regarding various issue of cancer patient's ache should the active treatment, stop pain the treatment to eliminate reduces patient's pain, but is also helpful to the enhancement quality of life, is helpful in anticancer treatment treatment smooth completion. The anticancer treatment treatment itself can control the ache, but the analgetic appearance requires certain time. Therefore, before radical cure anticancer treatment treatment appearance, also has the necessity to carry on the analgetic treatment positively, so that the anticancer treatment treatment can complete smoothly. In addition, regarding already the patient who loses the radical cure anticancer treatment treatment opportunity, stops pain possibly is the partial patients only may accept with the effective method of treatment, because the analgetic treatment possibly causes the tumor patient under the indolence condition the long-term belt cancer survival, strives for to treat the time and the opportunity.
(1) uses the pain-killer as far as possible early The control cancer pain's efficacious device is uses the analgetic medicine early, the prevention ache occurrence or prevents its aggravation. That is, if the ache appeared, do not wait till it becomes serious has treated again, but when just started, the use pain-relieving medicine control ache, like this obtains the effect is good, are also few with the dose. (2) not suitable pure dependent pain-killer The pure dependent pain-relieving medicine may not take. Because, each person is dissimilar to the pain-killer response. Not only this reflected that in the medicine variety, in the display drug efficacy's time, is the identical person uses the identical medicine, in the different time, the different environment produces the analgetic results to be also different. Must therefore pay attention to the flexibility in the pain-killer choice and the application method, and attempts to seek is suitable for own most effective analgetic method. While takes the analgetic medicine, may also apply the non-medicine pain-relieving method, like bodily relaxation therapy, distractive and so on. Not only this can enhance the analgetic effect, moreover causes the pain-killer to reduce with the dose, the working life lengthens, even cancels the medicine not to have the ache gradually.
The ache is the cancer most common symptom, but the cancerous ache is the patient and the family member most headache question. A some patient ache uses the painful piece and the Du cold fourth place medicine on the request, have never realized premature excessive easy to become addicted to and to have the drug resistance with this kind of medicine, therefore, plants regarding sickness is long and the ache light cancer patient, should use the psychotherapy and the physiotherapy stops pain, as soon as might as well tries. The psychological suggestion pain-relieving law is mainly strengthens patient oneself to defeat disease's confidence. May unify each cancer method of treatment, suggested how the patient does carry on own adjustment, tells him, if the coordinate treatment certainly can defeat disease, completes the eat three meals a day earnestly and carries on the essential recovery training, transfers oneself by this to annihilate the cancer cell most greatly fully ability, serves the analgetic purpose. The shift pain-relieving law may be called the patient to sit on a comfortable chair, closes both eyes to think the first childhood interesting may the happy matter, or thought are willing to think any matter, each time 20 minutes; May also like according to the patient, electing to put some lively high-sounding talk music, lets the patient on the one hand appreciate on the other hand does along with the rhythm hits movements and so on racket, subsequent party; May also let the patient look that some jokes, the humorous story, listen to section of crosstalks to seek pleasure. These may achieve the shift pain-relieving effect. The relaxation pain-relieving law whole body relaxation may give the human the light pleasant sensation, simultaneously the muscle relaxation may block the ache response. May be called the patient to shut the human to close both eyes, does sighs, yawns and so on movements, bows along with the retroflexion hip horizontal, relaxes the musculi abdominis, the musculi dorsi, the foot muscle, makes the abdominal breathing slowly. Or is called the patient to shut the item in the lonesome and quiet environment to carry on deep and the slow inspiration and the expiration, and along with breathes Lou 1, 2, 3 ......, causes the crisp air to enter the lung cancer, serves the analgetic purpose. The physical pain-relieving law may through stimulate the healthy side which around the ache the skin or corresponds to serve the analgetic purpose, the stimulation method may use the massage, spread the cool pain-killer and so on, may also use each kind of temperature to spread warm, blocks the ache information slightest sign of trouble cerebrum's transmission, if is Leng Shifu with the water bag or the cold wet towel, or places on the warm towel with 65 degrees hot-water bottles to make the hot compress, each time 20 minutes. The above method exchange application or the union application effect is better.
Some medicines will have the drug resistance, along with the condition extension, more will possibly stop on the need hurts the medicine, for example the cancer pain, some patients just started to eat one piece to suffice, along with cancer's proliferation, the ache spot have been getting more and more, the possible need bigger analgesia medicine, just to start our some patients eats one piece, we will internationally have the report, one day will even eat 100 pieces, now bears the medicine along with the medicine appearance the words, you may change other one medicine, you may also change other one way, for example some patients will eat the oral administration the anticancer treatment pain medicine, he eats quite uncomfortable, must eat such massively, sometimes after the shift, will have the gastro-intestinal tract change, the patient eats later to be disgusting, belly bulge specially fierce, if did not eat hurt awfully, therefore we have now introduced the new ache method of treatment, we had one kind of tube to put directly to the brain accumulate in the fluid, his medication only then we applied drugs normally 34%, like this might reduce many side effects, not only he might guarantee continued medication, moreover might also according to yours need, if evening sore fierce, might give the medicine, this kind of treatment was enters toAfter your body, does not affect your any life, also does not affect you to take a bath, oneself do not stop gives the medicine toward the body, to has needed to apply drugs increases, through in vitro remote control may solve.
Regarding the cancer patient, most frightened is not the death, but is the ache. But, is cannot avoid the ache all cancers to the later period? The Temple of Heaven hospital rather raises courtyard Dr. Wang to tell reporter, the cancer patient has the cancer pain the symptom to have the tumor reason, also has the patient to the ache sensitive reason. Speaking of the tolerance, some patient tolerance does not think the ache, but some thought that is very sore. Speaking of the tumor, some tumor ache, some tumor not too ache. Mainly has liver cancer, the cancer of the pancreas and the bone compared with ache cancer shifts. But feminine cervical cancer, the ovarian cancer are friends with some relatively, the lung cancer also has besides the ache feels suffocated the feeling, often is not hurts uncomfortably, but suppresses uncomfortably. 90% cancer painful patient may the indolence To control the cancer pain effectively, as early as in 1982, the World Health Organization (WHO) proposed famous "Cancer Three Steps and ladders Pain-relieving Guiding principle", according to this principle, with the existing analgesia medicine, may enable 90% cancer patient's ache to alleviate. Our country in December, 1990 introduced officially this principle the home. It is known that at present Beijing society healthcare department the free analgetic treatment which provides to the cancer painful patient, follows is three steps and ladders pain-relieving plan. According to this principle, the terminal cancer stops hurts uses 3 steps and ladders generally the drugs, based on this adds and subtracts the union medication. Beijing Temple of Heaven Hospital rather raises the courtyard Director Shao Jun introduced that the so-called three steps and ladders pain-relieving plan, is by specialized doctor, in makes the correct appraisal after the cancer pain's nature and the reason, divides into according to the ache fierce degree the ache the light, medium and heavy three ranks (steps and ladders), and defers to the ache the different rank choice different medicine. Selects the non-meconium class medicine to the mild ache's patient, selects the weak morphine class medicine to the moderate ache patient, needs to use the morphine preparation to the specific weight ache's patient. Beijing Temple of Heaven Hospital rather raises the courtyard Dr. Ma Zhen Shan gave an example saying that for instance hurt in view of the bone, adds the non-steroid body class drugs, the related nerve hurt, adds the clothing nerve pain-killer. Dr. Ma Zhenshan and Dr. Chen Fan explained in detail to reporter how three steps and ladders pain-relieving plan is applies on clinical: When sees a doctor to the patient, how listens to the patient is to carry on the indication to own ache, and defers to his indication to classify, then acts appropriately to the situation. For example: A 72 year-old person's condition is the lung cancer later period, in addition the bone shifts. The patient said that after his, back, the thigh, the crotch ache, looks like the acupuncture same ache to feel, moreover also has receives an electric shock the feeling. By now doctor inquiring about health person, if divides into the ache 10 levels, you thought that which you do belong first-level. The patient thought that he possibly occupies 5, 6 levels of appearances. Such doctor may judge patient's ache to belong to the moderate ache, may use the weak morphine class medicine, if the strong pain decides. Moreover, each time opens for patient's dose generally is a half month-long dose, therefore, every other a half month patients must come the hospital recipe.
The treat cancer ache most to be commonly used is also the most essential method namely for the pharmacotherapy. Pharmacotherapy's curative effect accurate, shows results quickly, is safe, is economical. But, still some quite many doctors or cancer patient stopped pain to the medicine did not understand, when an investigation discovery, carried on to the specific weight ache patient the pain-relieving treated, some 13.25% non-tumor specialized doctor first selects Du suddenly. Therefore reporter interviewed the Beijing University Tumor Clinical Institute, asks Director Di Lijun to chat the medicine pain-relieving. Cancer stops pain should follow three steps and ladders medication principle????? Director Di said that World Health Organization proposed the cancer painful pharmacological treatment's three steps and ladders medication principle, stresses according to the steps and ladders medicine; The oral administration gives the medicine; Takes medicine on time; The individuation gives the medicine; Attention nuts and bolts. According to the steps and ladders for the medicine is from weak to strong, gradually the increment, do not wait for the patient to need only then to use, but is in a disorderly way on time applies drugs. Insisting the individuation principle namely not so-called “the maximum dose” the limit, but take achieves the effective analgesia as the goal. Summarized some matters needing attention which in the long-term application the medicine stops pain, like should from the simple the dosage plan and the wound smallest pain-relieving therapy start; Best oral administration, if cannot take orally should consider that the rectum or after hypodermic gives the medicine; Do not use the placebo the treat cancer ache, cannot stop pain truly with the placebo, this to the patient is brutal; To the meconium class medicine, the different patient has the very big difference to untoward effect's sensitivity, time the application must pay attention; After the patient leaves the hospital, should give the written pain-relieving therapeutic schedule. The commonly used three steps and ladders stop pain which does the medicine have The non-steroid body antiphlogistic uses in the mild ache, often applies drugs has the aspirin, the paracetamol, the cloth Luo river fragrance, indomethacin and so on. To moderate ache available weak meconium class, like codein and so on. To specific weight ache available strong meconium as for example morphine, slow release morphine, multi-Switzerland lucky and so on. Cancer stops pain do not need to use Du suddenly and dihydro Egypt holds the Philippines??? Director Di Lijun said that Du's pain-relieving function suddenly for the morphine 1/8, stops pain the time only to be able to maintain two-and-a-half hours to three-and-a-half hours. This medicine to go to the armor in vivo metabolism pai for ding, it has the central nervous system poisonous function, cancer patient in the large dose after this medicine definitely will create the agglomeration, will present the poison, may appear trembles, the illusion, to twitch, the paramyoclonus and the epileptic paroxysm. Therefore, Du only may use in the short-time acute ache pain-relieving suddenly. Long-term use dihydro Egypt holds the Philippines to be possible to cause the obvious spiritual dependence and the body dependence, cannot use in the cancer pain the conventional treatment. In cancer stops pain with the meconium class does not need to worry that became addicted to Director Di saying that many patients and doctors worried will appear using the meconium class becomes addicted to, actually this kind of worry was nonessential. So-called becomes addicted to refers to the spiritual dependence, by now the patient cannot help but longs for obtaining the thing resourcefully, often take harmed the body and family happiness seeks the medicine as the price. Some item indicated to 10000 using the meconium class pain-relieving's cancer patient's investigation that has not presented the spiritual dependence in these patients. Another item demonstrated to 11882 using the meconium class pain-relieving's cancer patient's investigation that only some 4 patients present the spiritual dependence. Therefore the patient does not need to worry becomes addicted to the question. When using meconium class medicine presents the physiological dependence and the tolerance is the normal Pharmacology phenomenon, should not affect the medicine to continue the use. Director Di reminds that the long-term application meconium class medicine, specially produces the patient who to it bears the medicine, because is sensitive to the meconium class antagonist compound, after the breath suppresses corrects is been very easy to appear the serious abstention to break the symptom and the ache recrudescence. The standard medication can enable the overwhelming majority patient to get rid of the cancer pain. Some patients believed that I give an injection the pain-relieving to be useless, how many tablet of medicines do you let me take to be able to have an effect? Director Di introduced that kind thought the mouth takes medicine the analgetic effect to be bad, stops pain not the prompt idea is incorrect. The research indicated that according to three steps and ladders for the medicine principle, some 80%~90% cancer patient ache alleviates, but not the standard medication not only stops pain the effect not to be good, moreover the untoward effect occurs the proportion is also high. Therefore every may through the oral administration to the medicine treatment oral administration medication as far as possible. After other process standard medication was still unable the patient who relieves the ache effectively, may use other methods. Director Di said that along with the analgetic research's progress, was not at present is helpless to this part of patients.
Why not to use the psychotherapy and the physiotherapy The ache is the cancer most common symptom, but the cancerous ache is the patient and the family member most headache question. A some patient ache uses the painful piece and the Du cold fourth place medicine on the request, have never realized premature excessive easy to become addicted to and to have the drug resistance with this kind of medicine, therefore, plants regarding sickness is long and the ache light cancer patient, should use the psychotherapy and the physiotherapy stops pain, as soon as might as well tries. The psychological suggestion pain-relieving law is mainly strengthens patient oneself to defeat disease's confidence. May unify each cancer method of treatment, suggested how the patient does carry on own adjustment, tells him, if the coordinate treatment certainly can defeat disease, completes the eat three meals a day earnestly and carries on the essential recovery training, transfers oneself by this to annihilate the cancer cell most greatly fully ability, serves the analgetic purpose. The shift pain-relieving law may be called the patient to sit on a comfortable chair, closes both eyes to think the first childhood interesting may the happy matter, or thought are willing to think any matter, each time 20 minutes; May also like according to the patient, electing to put some lively high-sounding talk music, lets the patient on the one hand appreciate on the other hand does along with the rhythm hits movements and so on racket, subsequent party; May also let the patient look that some jokes, the humorous story, listen to section of crosstalks to seek pleasure. These may achieve the shift pain-relieving effect. The relaxation pain-relieving law whole body relaxation may give the human the light pleasant sensation, simultaneously the muscle relaxation may block the ache response. May be called the patient to shut the human to close both eyes, does sighs, yawns and so on movements, bows along with the retroflexion hip horizontal, relaxes the musculi abdominis, the musculi dorsi, the foot muscle, makes the abdominal breathing slowly. Or is called the patient to shut the item in the lonesome and quiet environment to carry on deep and the slow inspiration and the expiration, and along with breathes Lou 1, 2, 3 ......, causes the crisp air to enter the lung cancer, serves the analgetic purpose. The physical pain-relieving law may through stimulate the healthy side which around the ache the skin or corresponds to serve the analgetic purpose, the stimulation method may use the massage, spread the cool pain-killer and so on, may also use each kind of temperature to spread warm, blocks the ache information slightest sign of trouble cerebrum's transmission, if is Leng Shifu with the water bag or the cold wet towel, or places on the warm towel with 65 degrees hot-water bottles to make the hot compress, each time 20 minutes. The above method exchange application or the union application effect is better.
A European cancer ache Research center newest investigation showed that 2/3 cancer patient's ache index achieves above the medium degree, 1/4 patient ache index surpasses the fierce degree, they when ache rather chooses the euthanasia. Reduces the ache the key is between the medical trouble maintains the good communication in the ache question, guaranteed that the patient to applies each kind to stop hurts the medicine the confidence. According to the foreign news dispatch reported that the statistical data is in after the European 12 country more than 4000 cancer patient investigation and study obtains. The Research center indicated that this is about the cancer patient ache condition investigation, the participation population are most, most comprehensive one time.The report showed that the ache is causes 1/3 patients to the hospital seeing a doctor reason, but the majority patient conditions obtain effective treatment at the same time, cancer causes the ache has not obtained very well controls. This kind of ache formation rate is very high, and the duration is long. Some surpasses 1/3 patients to indicate that they endure such ache above one year. The investigation showed that the ache is affects one of the cancer patient quality of life and interpersonal relationship of important attributes. 68% believed by the surveyor, cancer brings the ache has affected the daily activity; 42% believed by the surveyor that the ache has affected them and family member's relations.Furlong elder brother · Germany Kang is located at Milan's Italian Country Cancer Research institute cancer recovery with the person in charge who reduces the group, is also the European cancer ache Research center recovery with the honorary manager who reduces the group. He said that the indisposition takes to patient's suffering is huge, is very actually difficult to the healthy persons very simple matter to them. This is causes the patient to choose one of euthanasia causes. Although has the medicine to be able to help the patient to reduce the ache, but the nearly 2/3 patients indicated that will appear frequently stops hurts the question which the medicament quantity will be insufficient. The investigation pointed out that some 1/4 was indicated by the surveyor, doctor does not sum up inquired they the ache situation, 1/3 believed by the surveyor, doctor not time attention ache question. Mary · curie cancer medical center medicine Consultant, the British Imperial family Medicine Academic society cancer recovery with reduces department's person in charge Terry sha · Dr. Tate to believe that solves the question key is between the medical trouble maintains the good communication in the ache question, guaranteed that the patient to applies each kind to stop hurts the medicine the confidence. Gram Li · Coverdale is an ovarian cancer patient. She said that cancer causes the ache has not experienced the human is unable to understand. At present, Coverdale after accepting the treatment is being restored to health gradually. She believed that the exchange is important, the patient should not endure this kind of pain silently, but should many and the family member, the friend as well as doctor exchanges.
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