姑息治疗晚期癌症老年患者的临床疗效研究  

Clinical Efficacy of Palliative Care for Elderly Patients with Advanced Cancer

作　　者：崔吉宏[1] 张金蓉[1] 

机构地区：[1]重庆三峡中心医院,404000

出　　处：《实用癌症杂志》2015年第3期469-471,共3页The Practical Journal of Cancer

摘　　要：目的评价姑息治疗晚期癌症老年患者的临床疗效。方法回顾性分析2012年12月至2013年12月持续接受治疗的晚期癌症患者的临床资料。疲劳评分≥4~10分的98例患者纳入本研究(由埃德蒙顿症状评估系统测定,ESAS),随机分为50例手术组患者和48例姑息组患者。患者的特点,ESAS评分和生存时间采用卡方检验、Wilcoxon秩和检验和Kaplan-Meier法检验。结果手术组和姑息组的ESAS疼痛中位分数分别为6分和4分((P<0.001);疲劳中位分数都是7分(P=0.525),抑郁症得分3分和2分(P=0.004),焦虑得分3分和2分(P<0.001),呼吸困难得分3分和2分(P<0.001),症状困扰评分分别为43分和32分(P<0.001)。总生存中位时间,姑息组是17.09个月(95%CI13.5~22.3个月),手术组是3.8个月(95%CI,3.5~4.1个月)(P<0.001)。姑息组患者疲劳状态比率显著低于手术组(P<0.05)。结论全面的姑息治疗可缓解晚期肿瘤患者症状,延长患者生存时间,提高生活质量。Objective To evaluate the clinical efficacy of palliative care for elderly patients with advanced cancer.Methods Clinical data of elderly patients with advanced cancer were retrospectively analyzed. 98 cases of patients with fatigue scores ≥4 ~ 10 from the Edmonton Symptom Assessment System( ESAS) were included in the study. Patients were divided into 2groups,50 cases received surgery and 48 cases received palliative care. Characteristics of patients,ESAS scores and survival time were detected by chi-square test,Wilcoxon rank sum test and Kaplan-Meier. Results ESAS median pain scores in the surgery group and the palliative care group were 6 points and 4 points( P < 0. 001),median score of fatigue in both groups were 7 points( P = 0. 525),depression scores were 3 points and 2 points( P = 0. 004),anxiety scores were 3 points and 2 points( P < 0. 001),dyspnea scores were 3 points and 2 points( P < 0. 001),symptom distress scores were 43 points and 32 points( P < 0. 001). The median overall survival time in the palliative group was 17. 09 months( 95% CI 13. 5 ~ 22. 3 months),and that of the surgery group was 3. 8 months( 95% CI,3. 5 ~ 4. 1 months)( P < 0. 001). The ratio of fatigue in the palliative group was significantly lower than that of the surgery group( P < 0. 05). Conclusion Comprehensive palliative care can relieve symptoms of advanced cancer patients,prolong survival time and improve quality of life of patients.

关 键 词：癌症相关的疲劳 姑息治疗 疲劳 晚期癌症 

分 类 号：R730.5[医药卫生—肿瘤]