2010_成人癌痛.pdf
2010_成人癌痛.pdf
Copyright © National Comprehensive Cancer Network 2010. All rights reserved. “NCCN”, the NCCN logo, and “National Comprehensive Cancer Network” are
registered trademarks of the National Comprehensive Cancer Network.
The Chinese edition of NCCN Clinical Practice Guidelines in Oncology-Adult Cancer Pain Guideline 2010 is the Chinese adapted version of NCCN Clinical Practice
Guidelines in Oncology-Adult Cancer Pain Guideline, V.1.2010 as permitted and endorsed by NCCN. It is the collaborative outcome of the National Comprehensive
Cancer Network and Chinese key opinion leaders of the field.
The original guideline and Chinese edition are both available at: http://www.nccn.org. To view the most recent and complete version of the guideline, go online
to www.nccn.org. These Guidelines and illustrations herein may not be reproduced in any form for any purpose without the express written permission of the
NCCN.
These Guidelines are a work in progress that will be refined as often as new significant data becomes available. The NCCN Guidelines are a statement of consensus
of its authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult any NCCN guideline is expected to use
independent medical judgment in the context of individual clinical circumstance to determine any patient's care or treatment. The National Comprehensive Cancer
Network makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
This publication should not be used for commercial purpose. It is provided for free to Chinese medical professions with the support of the unrestrictive educational
grant of Xian Janssen Pharmaceutical Ltd. which exerts no influence to the formation of the Chinese edition of NCCN Clinical Practice Guidelines in Oncology-Adult
Cancer Pain Guideline 2010.
肿瘤学临床实践指南(中国版)
2010年 第一版 成人癌痛NCCN ®
© National Comprehensive Cancer Network, Inc. All rights reserved. These guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN.
The Chinese edition 2010 is the collaborative outcome of the National Comprehensive Cancer Network and Chinese key opinion leaders of the field. Translated and adapted with permission and endorsement from the National Comprehensive
Cancer Network. To view the most recent and complete version of this or any other guideline, visit www.nccn.org.
* Robert Swarm, MD/Chair ϕ £
Siteman Cancer Center at Barnes-Jewish
Hospital and Washington University
School of Medicine
Amy Pickar Abernethy, MD † £
Duke Comprehensive Cancer Center
Doralina L. Anghelescu, MD ϕ
St. Jude Children’s Research
Hospital/University of Tennessee Cancer
Institute
Costantino Benedetti, MD ϕ £
The Ohio State University Comprehensive
Cancer Center - James Cancer
Hospital & Solove Research Institute
Craig D. Blinderman, MD, MA Þ £
Massachussetts General Hospital Cancer
Center
Barry Boston, MD £ †
St. Jude Children’s Hospital/University of
Tennessee Cancer Institute
Charles Cleeland, PhD θ
The University of Texas MD Anderson
Cancer Center
Nessa Coyle, PhD, NP £ #
Memorial Sloan-Kettering Cancer Center
Oscar A. deLeon-Casasola, MD ϕ £
Roswell Park Cancer Institute
NCCN 成人癌痛专家组成员
June G. Eilers, RN, PhD #
UNMC Eppley Cancer Center at The
Nebraska Medical Center
Betty Ferrell, RN, PhD £ #
City of Hope Comprehensive Cancer Center
Nora A. Janjan, MD, MPSA, MBA §
The University of Texas M. D. Anderson
Cancer Center
Sloan Beth Karver, MD £
H. Lee Moffitt Cancer Center & Research
Institute
Michael H. Levy, MD, PhD £ †
Fox Chase Cancer Center
Maureen Lynch, RN, NP £ #
Dana-Farber/Brigham and Women’s Cancer
Center
Natalie Moryl, MD Þ £
Memorial Sloan-Kettering Cancer Center
Barbara A. Murphy, MD £ †
Vanderbilt-Ingram Cancer Center
Suzanne Nesbit, PharmD, BCPS Σ
The Sidney Kimmel Comprehensive Cancer
Center at Johns Hopkins
Linda Oakes, RN, MSN #
St. Jude Children’s Research Hospital/
University of Tennessee Cancer Institute
Eugenie A. Obbens, MD, PhD £ Ψ
Memorial Sloan-Kettering Cancer Center
Judy Paice, PhD, RN £ #
Robert H. Lurie Comprehensive Cancer
Center of Northwestern University
Michael W. Rabow, MD £
UCSF Helen Diller Family Comprehensive
Cancer Center
Karen L. Syrjala, PhD θ
Fred Hutchinson Cancer Research
Center/Seattle Cancer Care Alliance
Susan Urba, MD £ †
University of Michigan Comprehensive
Cancer Center
Sharon M. Weinstein, MD £ Ψ
Huntsman Cancer Institute at the
University of Utah
ϕ 麻醉科
£ 支持治疗包括姑息治疗、疼痛处理、精神治疗
和肿瘤社会工作
† 肿瘤内科
Þ 内科
θ 精神病学、心理学，包括保健行为
# 护理科
§ 放射治疗/肿瘤放射科
Σ 药剂科
ψ 神经科/神经肿瘤科
* 编委会成员
NCCN ®成人癌痛 肿瘤学临床实践指南(中国版)2010年 第一版
© National Comprehensive Cancer Network, Inc. All rights reserved. These guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN.
The Chinese edition 2010 is the collaborative outcome of the National Comprehensive Cancer Network and Chinese key opinion leaders of the field. Translated and adapted with permission and endorsement from the National Comprehensive
Cancer Network. To view the most recent and complete version of this or any other guideline, visit www.nccn.org.
NCCN成人癌痛临床实践指南（中国版）专家组
组长：
于世英
华中科技大学同济医学院附属同济医院
王杰军
中国人民解放军第二军医大学长征医院
NCCN特别鸣谢
NCCN指南中国版专家组
召集人：
孙 燕
中国医学科学院北京协和医学院
肿瘤医院
NCCN代表：
Robert Swarm, MD
Siteman Cancer Center at Barnes-
Jewish Hospital and Washington
University School of Medicine
执笔人：
吴世凯
中国人民解放军三 七医院
罗 健
中国医学科学院北京协和医学院肿瘤医院
成员（按姓氏拼音排序）：
樊碧发
中日友好医院
黄 诚
福建省肿瘤医院
黄慧强
中山大学附属肿瘤医院
李萍萍
北京大学临床肿瘤学院、北京肿瘤医院
梁后杰
第三军医大学西南医院
刘小立
河北医科大学第四医院、河北省肿瘤医院
马胜林
浙江省肿瘤医院
宁晓红
中国医学科学院北京协和医学院北京协和医院
欧阳学农
南京军区福州总医院
秦叔逵
中国人民解放军第八一医院
王雅杰
第二军医大学附属长海医院
肖菊香
西安交通大学医学院第一附属医院
谢广茹
天津医科大学附属肿瘤医院
徐建国
南京军区南京总医院
臧爱华
湖北省肿瘤医院
张清媛
哈尔滨医科大学附属肿瘤医院
肿瘤学临床实践指南(中国版)
2010年 第一版 成人癌痛NCCN ®
© National Comprehensive Cancer Network, Inc. All rights reserved. These guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN.
The Chinese edition 2010 is the collaborative outcome of the National Comprehensive Cancer Network and Chinese key opinion leaders of the field. Translated and adapted with permission and endorsement from the National Comprehensive
Cancer Network. To view the most recent and complete version of this or any other guideline, visit www.nccn.org.
NCCN成人癌痛专家组成员
NCCN特别鸣谢
全面筛查和评估（PAIN-1）
未使用过阿片类药物患者的疼痛处理（PAIN-2）
未使用过阿片类药物的患者初始应用短效
阿片类药物（PAIN-3）
阿片类药物耐受患者的疼痛处理（PAIN-4）
阿片类药物耐受患者的后续疼痛处理和治疗（PAIN-5）
持续监护（PAIN-6）
疼痛强度评分（PAIN-A）
临床操作相关的疼痛与焦虑（PAIN-B）
目 录
作为共识，NCCN肿瘤学临床实践指南反映了作者们对目前认可的治疗方法的观点，欲参考或应用这些指南的临床医师应根据个人具体的临床情况做出独立的医疗判断，以决定患者所需的护理和治疗。任何寻求使用这些指南的
病人或非医生人员应咨询医生关于它们的合理应用。
NCCN肿瘤学临床实践指南编译力求精确表达反映原版英文指南。NCCN不保证指南编译的有效性，也不承认任何无限制性的担保、表达及暗示。NCCN不担保指南编译或指南本身的精确性和完整性。NCCN不保证或担保或陈
述指南的应用及应用结果。NCCN及其成员不对涉及指南无限制性应用的任何偶然的、间接的、特殊的、惩罚性或作为结果的补偿费承担任何责任。
全面疼痛评估（PAIN-C）
癌痛综合征的其他干预措施（PAIN-D）
阿片类药物的用药原则、处方、滴定和维持（PAIN-E）
阿片类药物不良反应的处理（PAIN-F）
神经病理性疼痛的辅助镇痛药物（PAIN-G）
社会心理支持（PAIN-H）
患者与家属宣教（PAIN-I）
非药物治疗（PAIN-J）
非甾体类抗炎药（NSAID）和对乙酰氨基酚处方（PAIN-K）
改善疼痛处理的专科会诊（PAIN-L）
介入治疗策略（PAIN-M）
讨论
参考文献
临床试验：NCCN认为任何肿瘤患者都可以在临床试验中得到最佳处理，因此特别
鼓励肿瘤患者参加临床试验研究。
NCCN对证据和共识的分类：
除非特别指出，NCCN对所有建议均达成2A类共识。见NCCN对证据和共识的分类
声明：
本指南中标注“※”处为中国专家根据国内实际
情况进行明显改动或补充之处，内容有别于英文版，
参考时请注意。
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