摘要
终末期患者可因顽固性症状产生无法忍受的痛苦,缓和镇静是通过降低患者意识水平而缓解痛苦的一种缓和医疗手段。规范的缓和镇静能够帮助患者有尊严地离世。与安乐死不同,缓和镇静并不改变患者的生存期。充分的缓和医疗是实施缓和镇静的前提,反复详尽的病情评估、多学科的共同参与是规范实施缓和镇静的必要条件。本文报道了北京协和医院安宁疗护缓和镇静临床诊疗流程规范,对其进行了解读,并以1例因顽固性谵妄接受缓和镇静的晚期肿瘤患者为例,展示了其在临床中的应用实践。
End-stage patients experience unbearable pain because of refractory symptoms.Palliative sedation is a form of palliative care which relieves patients'agony by lowering their consciousness.Standard palliative sedation can help patients die with dignity.It is distinct from euthanasia and does not alter the survival of patients.Sufficient palliative care is the premise of palliative sedation.Repeated and detailed clinical evaluation,as well as multidisciplinary involvement,is necessary for the standardized implementation of palliative sedation.Here,we proposed the standard process and specifications of palliative sedation in Peking Union Medical College Hospital.Furthermore,we reported a case of palliative sedation for an advanced cancer patient with refractory delirium and living pain to demonstrate its application in clinical practice.
作者
余佳文
刘红菊
宁晓红
戴晓艳
江伟
李妍
刘茜
沙蕊
郑莹
赵小萱
黄宇光
YU Jiawen;LIU Hongju;NING Xiaohong;DAI Xiaoyan;JIANG Wei;LI Yan;LIU Qian;SHA Rui;ZHENG Ying;ZHAO Xiaoxuan;HUANG Yuguang(Department of Anesthesiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Palliative Medicine Center,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of Geriatrics,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of International Medical Services,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Medical Intensive Care Unit,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of Emergency,PUMC Hospital,CAMS and PUMC,Beijing 100730,China)
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2023年第1期64-70,共7页
Acta Academiae Medicinae Sinicae
关键词
安宁疗护
缓和镇静
顽固性症状
palliative care
palliative sedation
refractory symptom
