Transcription of がん緩和療法マニュアル - nishimura-clinic.jp
1 QOL .. 5 . (1) . (2) . (3) . (4) .. (5) .. 1. 2 3 3. 2. 2 3 . 3.. Step3. Step2 . (5) . Step1 . NSAIDs .. WHO: Cancer pain . 1.. (1) (visual analog scale). 100 0 .. (2) Numerical Rating Scale . 10 . 0 10 11 .. WHO WHO . Step1 NSAIDs ( ) : 1 60mg(1 ) 1 3 . ( ) :1 200mg 1 2 . ( ), ( ) . 1 25 50mg 1 1 4 . ( ) . 1 100ml+ 50mg(1A) 1 2 3 . Step2 . :1 20mg(1 ) 1 4 :1 720mg ( ) 5mg 10mg 1 5mg 1 2 .. Step3 .. 10mg . ( )5mg 10mg . MS ( ) 10mg 30mg 60mg 20mg 30mg 60mg 120mg 10mg 20mg 30mg 10mg 50mg 200mg . ( ) (5mg) 10mg 20mg 40mg MT ( ) 2.. 1 . (60mg)3T/ or ( (200mg)2T/ . or (10mg)1T/ + ( )(20mg)1T/ . 2 . 2T 2+ (5)2T 2 + 1T / . + 3 3T / 2 3 + (250)6T 3/ . : ( ) 1P. 3 . 20mg/ MS .. ( ) .. 1 25 50% . 1 50 100% . 1 1/6 . 1 1/6 1 1/6 . 1 1 4 6 . 4 . 1/3 .. 5 .. 120mg .. 30 50%.)
2 10 (5 mg 2 2) 15(5 3 3 20(10 2 2) 30(10 3 3 40(20 2).. 60(20+10) 2 2 . MS 20 10 mg 2 2 30(10 3 3 40(10 4 2) 60(30 2 ).. 20 mg 30 40(30+10) 60 1.. MT. / 3 . 3.. 3 . 3 2. CSI . 3 . 3 CSI 1.. 60mg . 3 2.. 40mg 40mg 60mg 20mg . mg/ 30 60 120 240 360. mg/ 20 40 80 160 240. mg/ 20 40 80 160 240. MT mg/3 mg/ iv or mg/ 30 60 120 180. csi mg/ 4.. MT.. mg/ mg/ mg/3 .. 10 20 15 5 5 30 20 5 5 40 30 5 5 5. 60 40 10 10 5. 90 60 15 10 10. 120 80 20 15 15.. (95%) : .. ( ) ( ) ( . ). (30%) : 50% . 1-2 .. ( ):1 5-20mg or . ( ) or . (20%) : . 3 5 .. (2%): .. )1 6mg/ . ( ):1 20mg or . ( 5mg 1ml). 5.. neuropathic pain .. 3 .. ( . 120mg/ . 2% ( )100mg 15-30 .. 50ml+2% 100mg 5ml 15-30 .. ( ) ( ) ( . ) ( ) ( ).. ( )10mg/ 25mg/ 50mg/ 2.. ( ) . NMDA . 6.. 1 ( ) 1 8mg/ . 2 ( 10mg 25mg) 10 150mg/.)))
3 3 ( 200mg 300mg) 2 3T/ . ( ) 1T 6T/ . 4 NMDA ( ). 50mg/ml 50mg/ 5ml 3/ . 100 200mg/ .. NSAIDs . (4mg 5ml)+ 100ml 15 3 4 .. ( ) .. ( ).. 1 8mg 4 8mg . 2 4mg/ ( 1 2) 2 2mg . 1 3 4 . 16mg 2 4 .. 8mg / 2mg .. ( ) .. 7.. 2 4mg ( 4 8 ).. 20 50 .. : 5mg 1mg .. ) . (5mg)1ml 1/4 1/2 . (10mg)2ml 1/4 1/2 . ) . (3mg) 10mg . (100mg) . 200mg/day 300 500mg 24 .. 20mg/hr( ).. (1mg) . ) . ( )(2mg) . 1ml 1/4 1/2 .. ( ) . 300 g/ + 6 12mg/ + 10mg/ . ( ). 1 500ml . PEG .. 1 4mg/ 3mg 5mg 10mg . ( . 8.. 100ml+ 2mg 1A . : .. 1) 10mg or 10mg/A A . 6A/ . 2) . (1) mg/ mg/ .. (2) mg/ . 3) H(200mg) 2T 3T/ . ( ) .. 40 50 . 30 . P) . sedation 1A (10mg/2ml ) (10mg)1A+ 20mliv 2 3ml/ 3 or im = 1 (last 1 week) . 2 1 . / .. mean/median (SD). 57/23 (82). (18). (11).. ( ).. 9.. (50mg) 1 3 (25mg)1 1 3.
4 Or (3mg) or (10mg) . 10 / 30 10 / 1 . 1 3 1 3 .. 1 1/6 1 1/6.. or 4 8mg/ 8 16 (4 8mg)/ . or 30 60mg/ or 30 60mg/ .. (10mg) (3mg) (10mg) . 10 / 30 10 / 1 . 1 3 20 30 1 3 . 1/2 .. 1/2 1/2 . 1A (60mg) 1 . or (5mg) 1 1 3 . or 1A . or 1A . or (5mg)1A . (5mg) ( ) 1 . or P(25mg)1A or (3mg) 1 . (10mg) or (6mg) 1 . 10 / 30 10 / 1 . 1 4 1 3 . or (2mg) . 10 / 30 . 1 4 . (20mg)1A ( ) . or ( ) 1 1 3 . 30 1 3 . 50 100ml . 10. ADL .. ) 4 . ADL .. ADL .. 11. PS . Grade Performance Status . 0 .. 1.. 2. 50% . 50% . 3.. 4 . 12.
