The cancer pain relieves pain to make progress with nursing

The cancer ache is one of the cancer sufferer familiar symptoms, 50%~80% cancer sufferers have the degree the different ache, later period sufferer more Gao Da's 60%~90%, have 30% sufferers the at time of death ex- serious ache to can not get to alleviate around.The ache not only limits an activity and reduce appetite, influence sleep, while mentally willing also excel a sufferer, being ache to turn worse, the sufferer will produce worry anxiously and suppress Yu even commit suicide.The seriousness of cancer pain causes the value of World Health Organization(WHO), WHO is in drawing up the foundation of three stairs cancer pain treatment projects and put forward struggling of"let till 2000 cancer the sufferer isn't painful" target.Therefore, the cancer sufferer relieves pain a problem to more and more cause the value of the medical boundary and various communities.Relieve pain a cancer pain now method and nursing make one overview.
An ache's evaluating ache valuation is a cancer pain to control the most decisive one step, the treatment is ex- should make in details overall valuation to the ache.
The reason of 1.1 cancer aches:On being body factor, include:(1)The cancer causes and has 80%, such as tumor oppress, gradually and transfer;(2)Have relation with cancer treatment, have 10%, such as the surgical operation slice a people's scar formation, Huan limb pain, the chemotherapy cause of vein burning, put to treat behind partial damage etc.;(3)Be related to have 8% with cancer, such as long term crack-up little move, be constipated, muscle spasm;(4)Have nothing to do with the cancer to have 8%, such as bone arthritis etc..Two is society-mental factor, include to fear, worry anxiously, suppress Yu, cut up rough and standing alone etc..
The method of 1.2 cancer ache degree valuations the in common use valuation ache contain following 3 kinds of ratings methods currently, international up promote the application number ratings method more.
1.2.1 lords tell ache degree the ratings method(VRS) Be general to is divided into 4 classes: ache:0 classes have no pain;The Ⅰ class(light degree) has ache but can bear with, can be normal life, the sleep is free from interference;Ⅱ Class(mid-degree) the ache is obvious, can not bear with, request to use analgesic, the sleep is subjected to interference;Ⅲ Class(heavy degree) the ache is violent, can not bear with and sleep to be subjected to serious interference, can the companion contain independent nerve mess or passive body.
1.2.2 number ratings the method(NRS) is used the ache that 0~10 numbers represent different degree, 0 in order to have no pain, 10 is the most violent ache, let a sufferer the turn is a number that can represent its ache degree most by himself[herself].VRS and NRS two kinds of correlations of methods are:0~4 is a light degree;5~6 is mid-degree;7~10 is a heavy degree.
1.2.3 range estimation imitates the method(VAS-lineation method) uniform horizontal line(general is 10 cms), on carrying a representative to have no pain, another on carrying to represent the most violent ache, let sufferer's on-line segment is last by one's own feel can represent its ache degree most of the place Be uniform to cross line.
The principle of 1.3 ache valuations
1.3.1 believe that the sufferer's lord tells because the ache is the sufferer's subjective felling and be subjected to society-mental factor influence, be in need of the objective body advertises for, therefore want to believe a sufferer of lord tell, pay enough concern.
1.3.2 collectionses overall, the detailed ache history include sore outbreak time, part, degree, property, course of illness, keep on sex and interrupted sex, aggravate or ease of factor, ache treatment history, and the influence of the ache upon the sufferer and the family members...etc., should also have family members to provide and pit actually related circumstance.
1.3.3 attention the sufferer's relevant mental social factor of mental state and analysis because of overwhelming majority cancer the painful sufferer all exist fear, cutting up rough, suppressing of different degree Yu, worry anxiously, standing alone etc. mental obstacle, should discover in time and make to correspond valuation.
1.3.4 careful of physical examination and nervous system check the ache evaluation is to can not interrupted of work, need at any time emergence of noticing the new ache, because of ache of variety is disease development of signal, may be infection or bone fracture etc., so want a rightness keep on sex ache constantly evaluate afresh to make sure a new cause of disease.
2 relieve pain a method
2.1 pains in the medicine town
2.1.1 give medicine principle the treatment of the cancer ache contain a lot of methods, but many in the last yearses are domestic and international clinical experience think, the medicine treatment is a mainly depending on of the cancer ache treatment.WHO three the stairs cancer pain treatment the project is extensively exactly cancer painful medicine that the international top has already been accepted to cure a method, as long as correct follow the basic principle of that project, 90% cancer pains can get a good control.Have to obey five basic principles for medicine:Take orally, in fixed time, press the stairs, individuation to the medicine and notice a concrete detail.The general head chooses the non- Zi body anti- burning medicine(NSAIDs) treatment lightly to the mid-degree ache, in common use rush toward a hot interest pain, aspirin;If the ache keeps on or turns worse and increase(not is replace) in the non- Zi body anti- burning medicine slice medicine, if can treat because of or hydrogen can Tong;To keep on sex ache or ache beginning rise namely performance for in go to heavy degree, should choose a strong effect slice medicine or exaltation the slice medicine amount of, and as for amount of that assist to increase "when it's necessary", such as morphine product etc..Should increase an assistance to use a medicine while hasing no command over to the serious ache(if the oppression symptom, nerve that the tumor causes breaks or burns bright kind ache) in addition, such as the anti- surprised Jue medicine the card Ma Xi Ping, anti- suppress a Yu medicine the rice fill a rice to loosen for the wood and the ground etc..Someone suggests that if need to be continuous to use slice medicine, don't choose Mao to substitute Ding, because its function time is again short(only 2~3 hs), and use a medicine to cause central nervous system system toxicity.(tremor, consciousness misty, the epilepsy goes into action)
2.1.2 give medicine method slice relieves pain medicine to contain various types, under the possible condition, work hard for to take orally to the medicine, if the sufferer can not take orally and then choose rectum or didn't create sex to the medicine path through the skin, the end choice has already created to the medicine.
2.1.2.1 rectums have an effective simple method, safety for medicine and be applicable to have already swallowed a difficulty or severity disgusted, vomit.
2.1.2.2 make the medicine had already used at the sufferer slice medicine, but the ache is opposite to keep on, go into action not multifarious, the strength can't should consider being given a medicine by skin under the fast- ascending and descending circumstance.According to the report way, aroma too the Ni stick to spread to relieve pain to reach to a 72 hs, but be still hadn't a few limiting factors for medicine by skin.
Inject to inject inside the traditional muscle inside 2.1.2.3 muscles since the ache is again inconvenient, Dunwoody discovers inside the muscle and injects a method to 12%~15% sufferers is not enough town pain, and absorb unsteady, so don't lay claim to inject inside the muscle.
2.1.2.4 other currently have some lately to the medicine technique, such as sufferer from control to the medicine(PCA), this is to infuse to flow a pump through 1 kind, to vein inside release an axis analgesic thing in a row, level can make a Heng settled, attain painful purpose in the town thus, its safety and relieve pain a purpose more dependable.
2.2 anaesthesia techniques control ache
2.2.1 nerve Zu Zhi methods are used for medicine end nerve or physical method to melt medicine at the nerve and give to stimulate, thus temporarily or stop nerve conduction over a long period of time function.The nursing personnel should observe ache part and help doctor's fixed position and work well to prepare before the Shu and observe a sufferer to have all good reaction and relieves pain effect after curing while doing this treatment.
Mainly pass pipe or pump for medicine inside 2.2.2 spinal columns, continuous or interrupted to input the medicine into the hard film an outside or inside the sheath, but the hard sheath internal help outside the film is used an anaesthetic to cause breath's repressing.Therefore, place pipe in response to the breath appearance of tight surveillance sufferer.There is report way, cola settling's uniting for the medicine and morphine to use inside the Zhui tube can produce painful effect in the very strong town, can increase its function of effect and time, and have no toxicity to the nervous tissue, don't repress breath, is an analgesic thing inside the better a kind of foreground Zhui tube.The nursing for hard film outside to inputs medicine personnel should acquaint with the pharmacology function of medicine and observe sufferer's breath, blood pressure at any time, had better in the process of noting a medicine in and after 6~24 hs inside give a breath monitor.
2.3 neurosurgery techniques control a cancer pain to include nerve excision and place into medicine infusion the system and electricity nerve enhance a method.The nurse wants to acquaint with to dissect part, especially nerve alignment, match with a doctor to make good surgical operation, and avoid detention pipe infection.
2.4 other relieve pain a method
2.4.1 hypnotize can use to control to ache of felling, generally from once was subjected to exclusively disciplinal professional personnel's implementation.
2.4.2 Be stimulated nerve(TENS) incitement by skin electricity, the electrode can put in the ache part and close by skin stanza, attain to relieve pain effect with the method that the electricity stimulates.
2.4.3 pinpricks make use of specially made stainless steel's pinprick to alleviate ache into the muscle body certain acupuncture points, safe, simple and economic.There is report way, water needle treatment cancer pain contains accurate effect.Grow according to the disease and ache of the part choose different acupuncture points, the pinprick go into acupuncture points skin the bottom organize, the slowness injects.The in common use medicine settles for Lu pains, the ground fills a rice to loosen, the vitamin B12, inject a 0.5~1 mls each time, have the town the painful function through a veins and arteries.
2.5 alleviate a sore intervention technique
2.5.1 social mental state intervention the therapy have scholar to think in recent years, society mental state intervention the therapy can availably help a sufferer.Adopt cognition or behavior technique, teach to sufferer's some relevant aches and relieve pain the knowledge of treatment, help a sufferer to treat ache with the different standpoint, develop the technique of overcoming the ache, help the reaction that they change to the ache.
2.5.1.1 relax to think the energy that can transfer and scatter a sufferer to concentrate on the ache with idea.If the teaching makes use of to in brief eye breath to toughen to the sufferer, gradually relax a muscle, contemplate, music flabby method etc., thus at pleased that the idea thinks in make spirit and body attained a kind of flabby appearance to alleviate worry anxiously and ache.
2.5.1.2 dispersion attention and adjustment mood such as Mo number, sings a song, listens to music, watches television for oneself, and family and friend confabulation etc., make the sufferer's attention and mood transfered other incitement from the ache or the companion has of the bad emotion.
2.5.1.3 related education the evaluation concerning ache, ache, usage medicine and other alleviate a sore method to tell sufferer and family members, rectify the sufferer's false idea;Should also relieve a sufferer to slice medicine the addiction or medicine bear to be subjected to sexual of fear, make the sufferer actively participate in himself/herself nursing.
2.5.1.4 spirit consolations and society support encouraging a sufferer to take part in a social activity, such as the friend of anti-cancer association, disease support organization, and religion and faith...etc. and fight for support of the close relatives, disease's friend, friend and society, use aggressive mental emotion and stop sore vicious cycle.
2.5.2 skins stimulate such as the cold heat spread, massage, touch etc. flabby technique, ease a muscle strain, burning disease and the spasm cause of ache.
2.5.3 activities encourage a sufferer to keep movable dint possibly and want to in fixed time replace a body towards lying a bed sufferer and pass an appropriate activity to alleviate ache.
2.5.4 mental states support cancer pain and the sufferer's mental state's containing close relation, strain, fear, worry anxiously, suppress Yu etc. bad emotion all can lower ache of bearing and being subjected to dint.While using a medicine, work well a mental nursing, with active, enthusiasm, concern, encouragement the attitude of support, hear a sufferer to ache of lord tell and request, correspond by establishment of nursing plan and measure.Create good and comfortable treatment environment, including the room calmness of disease, sweep in addition, ample ray and just right indoor temperature, air fresh etc., ease the incitement toward the sufferer to be in conjunction with a medicine function, the exaltation relieves pain effect.