临床医生对终末期患者镇静治疗的经历和观点调查  

Clinicians ’ Practice and Opinions on Sedation Therapy in End-Stage Patients

作　　者：余佳文 刘红菊[1] 彭劲民 戴晓艳[3] 郑莹[4] 史迪[5] 宁晓红[4] 黄宇光[1] YU Jiawen;LIU Hongju;PENG Jinmin;DAI Xiaoyan;ZHENG Ying;SHI Di;NING Xiaohong;HUANG Yuguang(Department of Anesthesiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Medical Intensive Care Unit,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of International Medical Services,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Palliative Care Center,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of Emergency,PUMC Hospital,CAMS and PUMC,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院麻醉科,北京100730 [2]中国医学科学院,北京协和医学院,北京协和医院内科重症监护室,北京100730 [3]中国医学科学院,北京协和医学院,北京协和医院国际医疗部,北京100730 [4]中国医学科学院,北京协和医学院,北京协和医院缓和医学中心,北京100730 [5]中国医学科学院,北京协和医学院,北京协和医院急诊科,北京100730

出　　处：《中国医学科学院学报》2024年第1期62-67,共6页Acta Academiae Medicinae Sinicae

基　　金：白求恩公益基金会舒享科研基金(SX2022-006)。

摘　　要：目的调查北京协和医院不同科室临床医生对终末期患者镇静治疗的经历和观点。方法2022年8月至2023年4月对涉及终末期患者管理的临床医生进行线上问卷调查。结果共发放问卷205份,整体有效回收率56.1%。其中,55.7%的医生曾有对终末期患者实施镇静的经历。85.2%和75.7%的医生认为使用镇静药物可缓解终末期患者的躯体症状和心理生存痛苦。大部分医生因为担心缺乏法律支持(86.1%)和患者或家属不理解(59.1%)而对镇静治疗存在顾虑。90.4%的医生愿意接受缓和镇静培训。结论本次调查发现大多数医生认同通过镇静治疗缓解终末期患者的躯体症状和心理生存痛苦,但因缺乏法律法规支持而对镇静治疗的实施存在顾虑,需要加强缓和镇静培训。Objective To investigate clinicians’practice and opinions on sedation therapy in end-stage patients at Peking Union Medical College Hospital.Methods From August,2022 to April,2023,an online questionnaire survey was conducted among clinicians involved in end-stage patient management.Results A total of 205 questionnaires were distributed,with an effective response rate of 56.1%.Among the clinicians,55.7%of them had experience of applying sedation therapy in end-stage patients;85.2%of clinicians believed that sedation could relieve the suffering of terminal patients from physical refractory symptoms;75.7%of clinicians considered that sedation therapy could be used to relieve agony from psycho-existential distress.Most clinicians had concerns about sedation therapy due to the lack of legal support(86.1%)and the lack of understanding of patients or families(59.1%).The majority(90.4%)of clinicians were willing to receive training on palliative sedation.Conclusions A majority of clinicians agree that sedation therapy could relieve the physical distress and psycho-existential distress in end-stage patients.However,most clinicians have concerns about the application of sedation therapy due to the lack of legal support.It is necessary to enhance the training on palliative sedation.

关 键 词：终末期患者 镇静 缓和医疗 顽固性症状 

分 类 号：R48[医药卫生—临床医学]