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		<h1 class="catchCopy">がん疾患の特性・随伴症状に応じた痛みのコントロールを徹底解説！</h1>
		

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		<h1 class="title">病態・疾患別がん性痛の治療（電子版のみ）<span class="version"></span></h1>
		

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					編集：井関雅子（順天堂大学）
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					監修：表　圭一（禎心会病院）
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					<span class="transparent">監修</span>　山本達郎（熊本大学）
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">がん疾患ごとの抗がん治療や予後，随伴症状，痛みの特徴などの知識を解りやすく整理しつつ，痛みの治療ストラテジーを組み立てて紹介する．特に薬物療法と神経ブロック療法などの非薬物療法の両者に関しては，包括的な理解のもとに，上手に組み合わせながら治療をすすめられるよう記述を工夫した．簡潔で解りやすい記述と全ページカラーのビジュアルな誌面により，初学者からベテラン麻酔科医まで，興味とレベルにあわせて，読みたい項目を選んで読める．<br>☆表組102点，図版110点，カラー写真6点，モノクロ写真52点</section><section class="preface">「病態・疾患別がん性痛の治療」序文<br><br>　近年では，社会において緩和医療への関心が高まっており，がん性痛のコントロールを行う医療従事者の裾野も大きく広がっています．その理由として，本邦での死因の１位ががん疾患であること，また苦痛の緩和の重要性が国民全体に浸透してきたことが考えられます．したがって，がん性痛の治療も抗がん治療と並行して行う時代となっております．そのような中で，これまで出版されているがん性痛の緩和に関する書籍の大半が，すべてのがん患者に対して，WHO三段階ラダーを中心とした共通の薬物療法を適応させる方法の解説にとどまっていたように思われます．一方で，実際の臨床においては，患者が罹患しているがん疾患の特性や随伴症状などを理解したうえで，痛みのコントロールを行うことが求められています．そこで，がん性痛の治療に携わる医療従事者のニーズに応えるべく，本書を編集いたしました．<br>　本書では，がん性痛の病態を掘り下げながら，がん性痛の緩和に必要とされる種々の治療法を解説しております．また，疾患別に適切な痛みの治療が行えるように，各疾患に対する抗がん治療や予後，随伴症状，痛みの特徴などについて知識の整理ができるようにまとめたうえで，痛みの治療ストラテジーを組み立てて紹介しております．特に，薬物療法と非薬物療法の両者に関しては，包括的な理解のもとで，上手にさまざまな方法を組み合わせて治療が行えるよう工夫をさせていただきました．そのため，ご執筆の先生方には，多くのエネルギーを費やしていただく結果となりました．心より御礼申し上げます．<br>　初学者からベテランの医療従事者まで，日々の臨床において患者さんの苦痛軽減のため，本書が少しでもお役に立てれば幸いに存じます．<br><br>2013年10月<br>順天堂大学医学部麻酔科学・ペインクリニック講座　井関雅子</section><section class="indexes">総説<br>　がん性痛の定義と治療方針<br>解説<br>　Ⅰ．がん性痛の評価<br>　　1 がん性痛の評価<br>　　　T オピオイドの効果に影響する遺伝子多型<br>　　　T がんサバイバーの痛みの管理<br>　II．がん性痛の発生機序と治療<br>　　1 内臓痛<br>　　2 骨転移痛<br>　　3 がんに起因した神経障害性痛<br>　　4 治療に関連した神経障害痛・その他の痛み<br>　　　O くも膜下フェノールサドルブロックの効きが悪いときは？<br>　　　T 骨転移に対する経皮骨形成術：適応と治療効果<br>　　　T 脊髄刺激療法の適応と有用性<br>　　　T 神経障害性痛の機序解明最先端<br> III．がん性痛治療総論<br>　　1 薬物療法<br>　　　① 総論<br>　　　② NSAIDs・アセトアミノフェン<br>　　　③ オピオイド<br>　　　④ オピオイドの副作用対策：嘔気・嘔吐，便秘，眠気<br>　　　⑤ 鎮痛補助薬<br>　　2 神経ブロック療法<br>　　3 硬膜外鎮痛法とくも膜下鎮痛法<br>　　4 放射線療法<br>　　5 物理療法とリハビリテーション<br>　　　O オピオイドローテーションのコツとポイント<br>　　　O くも膜下鎮痛法にはどんな薬剤が使用可能か？<br>　　　O 抗うつ薬とプレガバリン/ ガバペンチンの使い分け<br>　　　O リドカイン静脈内投与の適応とコツ<br>　　　O がん性痛に対する超音波神経ブロックの活用法<br>　　　T リンパ浮腫に対するリンパドレナージの有用性<br>　IV．部位別：がん性痛の治療<br>　　1 頭頸部がん<br>　　　① 脳腫瘍<br>　　　② 顔面　口腔がん<br>　　　③ 甲状腺がん<br>　　　④ 咽頭がん<br>　　2 乳がん<br>　　3 肺がん<br>　　4 消化器系がん<br>　　　① 食道がん<br>　　　② 胃がん<br>　　　③ 肝臓がん<br>　　　④ 胆道がん<br>　　　⑤ 膵臓がん<br>　　　⑥ 大腸がん・直腸がん<br>　　5 婦人科系がん<br>　　6 泌尿器系がん<br>　　　① 腎臓がん<br>　　　② 膀胱がん<br>　　　③ 前立腺がん<br>　　　④（男性）生殖器がん<br>　　7 運動器系がん<br>　　　① 骨腫瘍<br>　　　② 軟部腫瘍<br>　　　③ 脊髄腫瘍<br>　　8 造血器系がん<br>　　　① 多発性骨髄腫<br>　　　② 白血病<br>　　　　O 高齢者に対するオピオイドのスムーズな導入法<br>　　　　O ケタミンの有効な使い方<br>　　　　O 持続皮下注の適応<br>　　　　T がん性痛緩和における超音波内視鏡ガイド下腹腔神経叢ブロック術の安全性と有効性<br>　　　　T がん性痛に対する経皮的コルドトミー<br>　Ⅴ．小児の緩和医療<br>　　1 小児の痛みの緩和<br>　　　T 基礎からみたオピオイドの差別化 ①<br>　　　T 基礎からみたオピオイドの差別化 ②<br>　　　T 基礎からみたがん性痛治療：ケモカイン<br>索引<br><br>T ＝ Topics<br>O ＝ One Point Advice</section></article>
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