Ключові слова
ноцицепція
фармакотерапія
наркотичні знеболювальні
ненаркотичні знеболювальні
Як цитувати
Анотація
In press
Наявність та адекватність знеболювання є одним з факторів істотного впливу на якість життя паліативних хворих. На сучасному етапі розвитку система паліативної та хоспісної допомоги в Україні не забезпечує якісне знеболення більшості пацієнтів. У зв’язку з цим ми провели дослідження літературних джерел на PubMed та Google Scholar, а також нормативно-правових актів України. Предметом вивчення був перелік і зміст різних аспектів болю та знеболення у паліативних хворих, які мають враховувати у своїй роботі медичні та соціальні працівники, що надають паліативну допомогу, а також організатори охорони здоров’я. Ми запропонували розширити наукову дискусію про види болю та відповідне ним знеболювання. Вивчення нормативно-правової документації про порядок надання паліативної допомоги в Україні та протоколу лікування хронічного болю у паліативних хворих виявило їх відповідність сучасним протоколам та правилам країн із розвиненими системами паліативної допомоги. Проте ми також виявили, що практична реалізація існуючих правил значно відрізняється їх невиконанням. Ми дійшли висновку про необхідність розширення використання наркотичних та ненаркотичних знеболюючих в українській паліативній медицині, зміцнення матеріально-технічної бази хоспісів та ліквідації їх кадрового дефіциту. У статті висвітлена низка питань патофізіологіїї болю. Ми визначили, що у питання відчуття болю паліативними хворими важливими є її причини, так і чутливість, яку можна оцінити за кількома шкалами у балах. Ми дійшли висновку, що адекватна реакція пацієнтів на біль спрощує діагностику та призначення адекватного лікування, а надмірна та «стоїчна» реакція їх ускладнюють. Ми зауважили, що лікування хронічного болю передбачає використання медикаментозної терапії, гіпнозу, когнітивно-поведінкової терапії, фізичних вправ та фізіотерапевтичних процедур.
Ключові слова: хронічний біль, ноцицепція, фармакотерапія, наркотичні знеболювальні, ненаркотичні знеболювальні.
Посилання
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