镇痛四阶梯与癌痛的优化管理  

The four-step analgesic ladder and optimal management for cancer pain

作　　者：邓硕曾[1] 张金华[1] 林磊 Deng Shuozeng;Zhang Jinhua;Lin Lei(Department of Anesthesiology,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing City 100078,China)

机构地区：[1]北京中医药大学东方医院麻醉科,北京市100078

出　　处：《中华疼痛学杂志》2021年第5期459-461,共3页Chinese Journal Of Painology

摘　　要：1986年WHO首次发布镇痛阶梯指南,即缓解癌痛的三阶梯镇痛方案。该指南简单清晰适用于70%~80%的癌痛患者,然而,癌痛的控制仍不够充分和满意。2010年有人对WHO癌痛阶梯提出修议,即所谓镇痛四阶梯。本文指出镇痛四阶梯不仅上升了一个台阶,更包含新近药理学和干预方法的创新,同时又保留了原有的简明。第四阶梯镇痛对治疗中度以上癌痛和非癌痛可能更有效更充分。The World Health Organization(WHO)first presented the analgesic ladder in 1986.It is a program of three-stepped analgesic ladder for cancer pain relief.This guideline is simple and clear,suitable for 70%-80%cancer patients.However,the cancer pain control is still inadequate and unsatisfactory.A new adaptation of WHO analgesic ladder has proposed in 2010,which is called four-step analgesic ladder.This paper points out that the four-step ladder is not only going up a new step but also encompasses the latest pharmacological and interventional innovations,while maintaining its original simplicity.The fourth step analgesic ladder may be more effective and adequate for treatment of moderate or severe cancer pain and noncancer pain.

关 键 词：镇痛阶梯 三阶梯 四阶梯 癌症疼痛 

分 类 号：R730.5[医药卫生—肿瘤]