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< 柿蔕湯（していとう）って、知っていたと？... | メイン | 医・食（職）・住：京都０番地（40番地）... >
2008.07.18 20:30 |  診療  |  その他（医療関連）  |  ミチバ  | 推薦数 : 2

ＡＣＰの緩和ケアのガイドライン

・私の机の上は，書類の山．山の底からは，ノアの方舟の破片がみつかるのではないかという位，歴史を刻んでおります．片付けども，片付けども次から次へと書類がやってくる，ワンコソバか，賽の河原か，という状態．（麺好きな私は，一度ワンコソバを食べてみたい）本日机の上を整理していると，次の様な文献が「発掘」されました．ご存じない方がいるかもしれないので，ご紹介しておきます．

ACP Clinical Practice Guideline

Evidence-Based Interventions to Improve the Palliative Care of Pain, Dyspnea, and Depression at the End of LIfe: A Clinical Practice Guideline from the American College of Physicians

Ann Intern Med 2008;148:141-146

 

 ちなみに，以下のWebsiteでいろんなガイドラインがみることができます．

http://www.acponline.org/clinical_information/guidelines/

 

・一言だけこれに関連して，思い出を．

このガイドラインのDyspneaのところには，Evidence from 13 studies shows a valuable effect of morphine for dyspnea in advanced lung disease.とあります．今では，多分常識ではないででょうか？私の若かりし頃，ＷＨＯの緩和ケアのガイドラインが出て，それを普及させようと関係のDr.方が努力されていた頃．モルフィネに関して，大学の医師にアンケートをとった結果の発表をきいたことがあります．モルフィネが呼吸困難に効くということを知らないDr.が半数以上ということに唖然とした記憶があります．大学というところは，「こんなもんか」と再認識（色々問題あるところと思っていたので）したことを覚えております．

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