復(fù)旦大學(xué)上海醫(yī)學(xué)院腫瘤學(xué)系(已修改)
2025-07-30 19:39 本頁面
【正文】 復(fù)旦大學(xué)上海醫(yī)學(xué)院腫瘤學(xué)系 Fudan University Shanghai Cancer Center 《 Basic Clinical OncologySymoptom Management and Palliative Care》 Pain Fudan University Cancer Center Cheng WenWu Who am I? ?Cheng WenWu ? Director of palliative care department, Shanghai cancer hospital, Fudan university. ? Traditional Chinese Medicine (Shanghai) and palliative care (MD Anderson cancer center, Texas) Overview of pain ? major symptoms in cancer patients: either early or advanced stage ? global mon problem: 30% to 50% of new cancer patients 。 advanced patients reach 70% to 90%. Definition of pain ? an unpleasant sensory and emotional experience associated with actual or potential tissue injury or described in terms of such damage. ? “injury” and “suffering or distress” ?“ Pain is whatever the experience the person says it is, existing whenever patient says it does” ? The patient39。s chief plaint should be believed. Impact of pain ? The interaction of pain with concurrent symptoms such as anorexia, nausea, constipation, delirium, dyspnea, depression, anxiety and insomnia, and so on. ? The patients and their families might think that the intensification of pain is a harbinger of impending death. Causes of pain ? Tumor: ① tumor pression and invasion to adjacent ans, tissue, nerves, bones or blood vessels or metastasis.② inflammation caused by tumorinduced mediators (, interleukin, bradykinin) and so on. ? Treatmentrelated: ① Postsurgical pain syndrome (eg, thoracotomy, mastectomy, amputation surgery, surgical scars and nerve damage).② Postchemotherapy pain (eg, polyneuropathy, osseous necrosis, thrombophlebitis and mucositis).③ Postradiation pain (eg, local damage, neural fibrosis, medullary lesions, bone necrosis and mucositis). ? Cancerrelated pain: the pain is caused by some symptoms such as constipation, pressure sores and muscle spasm. ? Nonphysiological pain: ① Spiritual pain.② Psychological trauma. ? Noncancer pain: noncancerrelated pain (eg, myofascial, musculoskeletal problems). ? There are two or more causes of p
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