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阿尔兹海默病和其他类型痴呆患者疼痛的识别和管理

2016-07-22 佚名 环球医学

阿尔兹海默病患者的疼痛及疼痛管理是一项复杂的问题。2016年6月,发表在《CNS Drugs.》的一项系统评价对阿尔兹海默病和其他类型痴呆患者疼痛的识别和管理进行分析。背景和目的:阿尔兹海默病患者的疼痛是一项复杂的问题,这些患者会遭受常见病因的急性和慢性疼痛,一些也具有神经性或伤害性疼痛。无论这些患者中的疼痛机制如何,他们的疼痛都将需要仔细的评估和管理,从而确保给予了正确的镇痛类型和镇痛水平。本系

阿尔兹海默病患者的疼痛及疼痛管理是一项复杂的问题。2016年6月,发表在《CNS Drugs.》的一项系统评价对阿尔兹海默病和其他类型痴呆患者疼痛的识别和管理进行分析。

背景和目的:阿尔兹海默病患者的疼痛是一项复杂的问题,这些患者会遭受常见病因的急性和慢性疼痛,一些也具有神经性或伤害性疼痛。无论这些患者中的疼痛机制如何,他们的疼痛都将需要仔细的评估和管理,从而确保给予了正确的镇痛类型和镇痛水平。本系统评价的目的为鉴别出符合以下条件的研究,养老院生活和人生终点期间,调查不同的镇痛剂对疼痛强度或疼痛相关行为的有效性。

方法:使用疼痛、疼痛治疗、痴呆等MESH词和关键词对Medline、Embase、PsychINFO、CINAHL、Cochrane图书馆进行文献检索(截止到2015年10月15日)。

结果:检索产生了发表于1990至2015年10月期间的3138个单一条目。研究人员对标题和摘要进行了阅读,鉴别出124篇文献进行全文评估,并纳入了12篇文献来反映和合成以下问题:(1)痴呆者使用哪种疼痛评估工具可对疼痛强度评分的改变具有应答?(2)对于生活在养老院中的痴呆人员,包括生命尽头者,哪种镇痛剂是对照试验检测有效的?(3)哪种结局测量可用于痴呆患者疼痛、疼痛行为、和/或治疗有效性的鉴别?

结论:尽管镇痛剂的使用增加,但是痴呆患者仍然较多发生疼痛。虽然具有有效的疼痛评估工具,但是未被实施,也没有完全用于检测对治疗的应答。针对养老院的痴呆患者的疼痛评估和治疗的官方指南是缺乏的。几乎没有对镇痛药治疗痴呆相关的疼痛或神经精神行为的有效性进行过研究。


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  2. [GetPortalCommentsPageByObjectIdResponse(id=2009076, encodeId=2ab120090e653, content=<a href='/topic/show?id=3ed8e121172' target=_blank style='color:#2F92EE;'>#痴呆患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71211, encryptionId=3ed8e121172, topicName=痴呆患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4aa106, createdName=crystal0562, createdTime=Sat Sep 03 04:11:00 CST 2016, time=2016-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145445, encodeId=d33714544558, content=好文值得点赞!继续关注学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Oct 11 20:21:57 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1402687, encodeId=f7c9140268ef5, content=<a href='/topic/show?id=60ca9e761ce' target=_blank style='color:#2F92EE;'>#阿尔兹海默#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97761, encryptionId=60ca9e761ce, topicName=阿尔兹海默)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=be952422716, createdName=habb, createdTime=Sun Jul 24 01:11:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94257, encodeId=a7909425e95, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Sat Jul 23 11:25:00 CST 2016, time=2016-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94165, encodeId=87c7941659f, content=那只有对症治疗痴呆性疼痛啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Fri Jul 22 17:15:00 CST 2016, time=2016-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94136, encodeId=699f9413663, content=学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Fri Jul 22 15:03:00 CST 2016, time=2016-07-22, status=1, ipAttribution=)]
    2016-10-11 ylzr123

    好文值得点赞!继续关注学习。

    0

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    2016-07-23 oo902

    好好学习

    0

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    2016-07-22 医路开来

    那只有对症治疗痴呆性疼痛啦

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2009076, encodeId=2ab120090e653, content=<a href='/topic/show?id=3ed8e121172' target=_blank style='color:#2F92EE;'>#痴呆患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71211, encryptionId=3ed8e121172, topicName=痴呆患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4aa106, createdName=crystal0562, createdTime=Sat Sep 03 04:11:00 CST 2016, time=2016-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145445, encodeId=d33714544558, content=好文值得点赞!继续关注学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Oct 11 20:21:57 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1402687, encodeId=f7c9140268ef5, content=<a href='/topic/show?id=60ca9e761ce' target=_blank style='color:#2F92EE;'>#阿尔兹海默#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97761, encryptionId=60ca9e761ce, topicName=阿尔兹海默)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=be952422716, createdName=habb, createdTime=Sun Jul 24 01:11:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94257, encodeId=a7909425e95, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Sat Jul 23 11:25:00 CST 2016, time=2016-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94165, encodeId=87c7941659f, content=那只有对症治疗痴呆性疼痛啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Fri Jul 22 17:15:00 CST 2016, time=2016-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94136, encodeId=699f9413663, content=学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Fri Jul 22 15:03:00 CST 2016, time=2016-07-22, status=1, ipAttribution=)]
    2016-07-22 1dd8c52fm63(暂无匿称)

    学习学习!

    0

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