最新因治疗引起的癌症疼痛护理-药学医学精品资料.ppt

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1、最新因治疗引起的癌症疼痛护理-药学医学精品资料癌症疼痛疼痛也可以由肿瘤的治疗所致，包括手术、化疗、放疗、免疫治疗和生物治疗。如开胸术后疼痛、化学治疗引起的周围神经损伤性疼痛、放射治疗诱发的粘膜炎疼痛，与癌症诊治有关的疼痛占22.9%导致癌症疼痛的病因(一)中医治疗癌症由癌症本身引起　　大多数疼痛是由肿瘤直接侵犯骨骼、神经、软组织及内脏所致。如癌肿压迫骨、神经、内脏、，皮肤和软组织的侵犯、转移，癌症本身引起的疼痛占63.2%。　　(二)社会心理因素　　由于癌症诊断、对治疗及预后的担心，造成病人巨大的心理压力，增加了病人的恐惧、焦虑、

2、抑郁、愤怒、孤独感，使病人对疼痛的敏感性增加。与精神、心理因素有关的疼痛占13.9%。“Toomuch”and“toolittle”costsCo=overagecostThecostoforderingonemoreunitthanwhatyouwouldhaveorderedhadyouknowndemand.Inotherwords,supposeyouhadleftoverinventory(i.e.,youoverordered).Coistheincreaseinprofityouwouldhaveenjoyedhadyou

3、orderedonefewerunit.Cu=underagecostThecostoforderingonefewerunitthanwhatyouwouldhaveorderedhadyouknowndemand.Inotherwords,supposeyouhadlostsales(i.e.,youunderordered).Cuistheincreaseinprofityouwouldhaveenjoyedhadyouorderedonemoreunit.Balancingtheriskandbenefitoforderinga

4、unitOrderingonemoreunitincreasesthechanceofoverage…ExpectedlossontheQthunit=CoxF(Q)F(Q)=Distributionfunctionofdemand=Prob{Demand<=Q)…butthebenefit/gainoforderingonemoreunitisthereductioninthechanceofunderage:ExpectedgainontheQthunit=Cux(1-F(Q))Asmoreunitsareordered,theex

5、pectedbenefitfromorderingoneunitdecreaseswhiletheexpectedlossoforderingonemoreunitincreases.NewsvendorexpectedprofitmaximizingorderquantityTomaximizeexpectedprofitorderQunitssothattheexpectedlossontheQthunitequalstheexpectedgainontheQthunit:Rearrangetermsintheaboveequati

6、on->TheratioCu/(Co+Cu)iscalledthecriticalratio.（临界比或关键比例）Hence,tomaximizeprofit,chooseQsuchthatwedon’thavelostsales(i.e.,demandisQorlower)withaprobabilitythatequalsthecriticalratioTheNewsvendorModel:Performancemeasures绩效指标NewsvendormodelperformancemeasuresForanyorderqu

7、antitywewouldliketoevaluatethefollowingperformancemeasures:Expectedlostsales（期望销售损失）TheaveragenumberofunitsdemandexceedstheorderquantityExpectedsales（期望销售）(comparedtoexpecteddemand)Theaveragenumberofunitssold.Expectedleftoverinventory（期望售后剩余库存）Theaveragenumberofunitsleft

8、overattheendoftheseason.ExpectedprofitExpectedfillrate（期望订单完成率）Thefractionofdemandthatissatisfiedimmedi