影响不同职称肿瘤医师在临床实践中对于使用地塞米松治疗癌痛的因素  

Analysis on the influencing factors for the prescription of dexamethasone in the treatment of cancer pain by oncologists with different professional titles in clinical practice

作　　者：江丽华 郑锐年[1] 梁宝方[1] 黄嘉利 周经纬 JIANG Lihua;ZHENG Ruinian;LIANG Baofang;HUANG Jiali;ZHOU Jingwei(Office of Drug Clinical Trial Institution,Dongguan Hospital Affiliated Southern Medical University(Dongguan People’s Hospital),Guangdong,Dongguan 523000,China)

机构地区：[1]南方医科大学附属东莞医院(东莞市人民医院)药物临床试验机构办公室,广东东莞523000

出　　处：《中国医药科学》2022年第20期115-119,共5页China Medicine And Pharmacy

基　　金：广东省东莞市科技计划项目(2018507150011283)。

摘　　要：目的探讨影响不同职称的肿瘤医师在使用地塞米松作为癌痛辅助用药的因素。方法为调查肿瘤医师处方地塞米松的经验和观点,对来自华南7家教学医院的肿瘤医师进行一次简单的问卷调查。结果问卷回收率94.44%。在不同职称的肿瘤医师之间,“在癌症患者中使用地塞米松治疗常见非特异性适应证”和“是否处方地塞米松为辅助止痛药来治疗服用阿片类药物无法控制癌痛的患者”两项认识上差异无统计学意义(P>0.05)。在不同职称的肿瘤医师之间,影响地塞米松使用的因素方面,差异有统计学意义(P<0.05)。不同职称的医师在低剂量(4~8 mg)和中剂量(8~16 mg)的选择比例较为接近。在地塞米松的滴定方法上,不同职称的肿瘤医师的观点基本一致,差异无统计学意义(P>0.05)。不同职称的肿瘤医师在胃保护剂的选择上差异较大,差异有统计学意义(P<0.05)。结论临床医师应建立地塞米松辅助治疗癌痛的使用规范,进一步协助肿瘤医师开展临床实践。在诊疗上不应仅局限于获取经验主义,更应扩宽视野,加强对循证医学等技术方法的了解,从而更好地服务患者。Objective To explore the factors affecting the prescription of dexamethasone as an adjuvant drug for cancer pain by oncologists with different professional titles.Methods A simple questionnaire survey was conducted among oncologists from 7 teaching hospitals in South China,so as to investigate the experience and views of oncologists in prescribing dexamethasone.Results The questionnaire response rate was 94.44%.There were no statistically significant differences among oncologists with different professional titles in the view of"using dexamethasone for common non-specific indications in cancer patients"and"whether to prescribe dexamethasone as an auxiliary analgesic to treat patients with cancer pain that cannot be controlled by taking opioids"(P>0.05).There was statistically significant difference among oncologists with different professional titles in the factor affecting the prescription of dexam ethasone(P<0.05).Oncologists with different professional titles chose low dose(4-8 mg)and medium dose(8-16 mg)in a similar proportion.In terms of the titration method of dexamethasone,the opinions of oncologists with different professional titles were basically the same,and the difference was not statistically significant(P>0.05).There was statistically significant difference in the choice of gastric protective agents among oncologists with different professional titles(P<0.05).Conclusion Clinicians should establish the medication standard of dexamethasone in the adjuvant treatment of cancer pain,which can further assist oncologists in clinical practice.In diagnosis and treatment,oncologists should not only be limited to empiricism,but also broaden horizons and strengthen the understanding of evidence-based medicine and other technical methods,so as to better serve patients.

关 键 词：地塞米松 癌痛 不同职称 经验用药 

分 类 号：R730.5[医药卫生—肿瘤]