摘要
血管阻塞性危象(VOC)又称镰状细胞疼痛危象,是镰状细胞病(SCD)的标志性并发症,临床表现复杂,通常伴有急性疼痛。不能有效控制、反复发作的疼痛是患儿入院的主要原因,因此,安全有效地进行疼痛预防及控制至关重要,药物治疗是最主要方式之一。本文整理归纳国内外SCD患儿VOC治疗的有限资料,从儿童VOC疼痛成因、疼痛评估及药物治疗三个方面进行综述,其中,药物治疗部分包括非阿片类药物、阿片类药物、辅助镇痛药物治疗以及预防疼痛危象药物治疗。SCD患儿疼痛危象的治疗与预防中应注重多模式镇痛的应用,基于患儿个体特征慎重选择镇痛方案,减少阿片类药物使用剂量,避免不良反应的发生,从而提升镇痛效果,改善患儿生活质量。
Vaso-occlusive crises(VOC),also called pain crisis,is a hallmark complication of sickle cell disease(SCD)and a complex clinical manifestations,usually associated with acute pain.Inability to effectively control recurrent pain is a major cause of children admitted to hospital.Therefore,safe and effective pain prevention and control is the key to the treatment of this disease,and drug therapy is one of the most important ways.This paper summed up the limited data on pain treatment of children with SCD at home and abroad,and summarized the cause,evaluation and drug treatment of childhood VOC pain.Among them,the section of“drug treatment”included non-opioid drugs,opioid drugs,auxiliary analgesic drugs,and drug treatment to prevent VOC.In the treatment and prevention of pain crisis in children with SCD,attention should be paid to the application of multimodal analgesia,the analgesic plan should be carefully selected based on the individual characteristics of the child,the dosage of opioid drugs should be reduced,the adverse reactions should be avoided,so as to improve the analgesic effect and quality of life.
作者
谢菡
陈心怡
马旭东
葛卫红
XIE Han;CHEN Xinyi;MA Xudong;GE Weihong(Department of Pharmacy,Drum Tower Hospital,Medical College of Nanjing University,Nanjing 210008,China;School of Pharmacy,Nanjing Medical University,Nanjing 211166,China;School of Basic Medicine and Clinical Pharmacy,China Pharmaceutical University,Nanjing 211199,China)
出处
《药学与临床研究》
2024年第1期51-56,共6页
Pharmaceutical and Clinical Research
基金
国家自然科学基金项目(72104105)
江苏省研究型医院学会2021年度精益化用药-石药专项科研基金(JY202112)。
关键词
镰状细胞病
儿童
疼痛危象
药物治疗
Sickle cell disease
Children
Pain crisis
Drug treatment
