优化解决肺癌患者在新型冠状病毒肺炎疫情期间诊疗问题及心理问题的探索  

Explore the Optimal Resolvent of Medical Needs and Mental Health for Patients with Lung Cancer during Epidemic Novel Coronavirus Pneumonia

作　　者：徐海燕[1] 杨科 杨广建 杨路 米玉玲 崔晓红 杨敏[1] 王丹[5] 王燕[3] Haiyan XU;Ke YANG;Guangjian YANG;Lu YANG;Yuling MI;Xiaohong CUI;Min YANG;Dan WANG;Yan WANG(Department of Comprehensive Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100021,China;Department of Comprehensive Oncology,Huanxing Cancer Hospital,Chaoyang District,Beijing 100005,China;Department of Medical Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100021,China;Lung Cancer Center,Sanhuan Cancer Hospital,Beijing 100122,China;Depression Treatment Center,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China)

机构地区：[1]国家癌症中心/国家肿瘤临床研究中心,北京协和医学院,中国医学科学院肿瘤医院综合科,北京100021 [2]北京市朝阳区桓兴肿瘤医院综合科,北京100005 [3]国家癌症中心/国家肿瘤临床研究中心,北京协和医学院,中国医学科学院肿瘤医院肿瘤内科,北京100021 [4]北京市朝阳区三环肿瘤医院,北京100122 [5]首都医科大学附属北京安定医院抑郁治疗中心,北京100088

出　　处：《中国肺癌杂志》2020年第4期247-254,共8页Chinese Journal of Lung Cancer

摘　　要：背景与目的随着新冠肺炎(novel coronavirus pneumonia,NCP)在全世界范围内的迅速蔓延及防控工作的升级,肺癌患者常规诊疗需求因疫情原因受到不同程度的限制,有必要了解肺癌患者在疫情期间诊疗需求及心理健康情况,为后续的诊疗提供合理化建议。方法采用电子问卷的形式,2020年3月4日7点发放,至3月6日7点截止,48 h收回368份问卷,覆盖了25个省自治区/直辖市。结果368例肺癌患者,18例未行抗肿瘤治疗,最终纳入分析的患者共350例。229例口服靶向治疗,化疗或免疫治疗治疗121例。41.3%静脉注射化疗或免疫治疗患者出现治疗中断,中断比例较口服靶向治疗高(21.0%)。无论是口服靶向治疗还是静脉化疗或免疫治疗,超过60%患者出现影像学检查延迟。近1/3患者出现新发症状或原有症状加重,26.6%-28.9%患者通过网络咨询后更改了治疗方案。40%-75%肺癌患者在NCP期间存在心理健康问题,95%以上的肺癌患者对国家采取疫情防控措施表示支持和有信心。结论在NCP期间,肺癌患者诊疗需求未得到满足,以化疗或免疫治疗的患者更明显,医疗机构恢复工作时应考虑优先解决。同时对患者存在的心理健康问题,应予以关注和疏解。Background and objective With the rapid spread of novel coronavirus pneumonia(NCP)worldwide and the escalation of prevention and control efforts,the routine medical needs of patients have been restricted.The aims were to investigate medical needs of lung cancer patients and their mental health status during the epidemic periods,so as to provide rational recommendations for subsequent diagnosis and treatment.Methods The questionnaire was sent in the form of an electronic questionnaire at 7am on 4th,March,2020,until 7am 6th,March,2020,368 questionnaires were recollected from 25 provinces(autonomous regions/municipalities)in 48 h.Results Of the 368 patients,18 patients were excluded as they didn’t receive anti-tumor treatment,and 350 patients were included in the final analysis.229 cases were treated with oral targeted drugs,and 121 cases were treated with chemotherapy or immunotherapy.41.3%of patients treated with intravenous chemotherapy or immunotherapy experienced treatment discontinuation,and the proportion of treatment discontinuation in chemotherapy or immunotherapy was higher than those treated with oral targeted drugs(21.0%).Whether oral targeted drugs or intravenous chemotherapy or immunotherapy,more than 60%of patients experienced delays in imaging examinations.Nearly one third of patients developed new symptoms or exacerbation of existing symptoms.26.6%-28.9%of patients have changed their treatment plans through online consultation.During novel coronavirus pneumonia,40%-75%of lung cancer patients have mental health problems,and more than 95%of patients support government’s prevention and control measures.Conclusions During the emergence of NCP,the medical needs of patients with lung cancer have not been enough,especially those who discontinued chemotherapy or immunotherapy.When medical institution resumes work,priority should be given to them.At the same time,mental health problems of patients should be valued and resolved timely.

关 键 词：肺肿瘤 新冠肺炎 心理健康 

分 类 号：R734.2[医药卫生—肿瘤]