肿瘤生存者随访模式和数据管理的初步探讨

Studies of database management and surveillance models for cancer survivors

目的大型医疗机构肿瘤患者来自各地,肿瘤治疗后,如何长期进行肿瘤生存者随访是必须面临的科学难题,本文就北京协和医院肿瘤生存者数据管理进行总结,并探讨肿瘤生存者的随访模式。方法建立肿瘤生存者管理数据库和随访制度,对目前纳入管理的数据内容进行总结,探讨患者一般状况,并对存在的随访模式进行随访率统计,比较其特点。结果自2005年6月1日～2009年2月15日,共录入患者数为2081个,患者来源于全国各地,主要集中在北京及河北省、河南省、辽宁省、山西省及山东省。其中男性患者占总患者数的56.62%;女性患者占总患者数43.38%,常见肿瘤如肺癌、大肠癌等占2/3,其他肿瘤占1/3。随访模式存在传统的被动模式、主动回顾模式、程序随访模式和社区-医院模式四种。结论传统的被动模式随访率低,主动回顾模式仅适合生存期的随访,程序随访模式社区仅用于临床试验。社区-医院模式随访需要不同医疗机构之间的合作,随访的质量和数据完整性最高,对患者指导意义更大。

Objective To investigate the application of patient database and follow-up models. Methods The demographic character of cancer survivors in our department were retrospectively analyzed. Results From June 1, 2005 to Feb 15, 2009, there were 2081 patients recorded. Patients mainly came from Beijing and north part of China. Models of surveillance included patient passive visit, active retrospective return call, programmed follow-up and community-hospital combined models. Patient passive visit was economic but with lowest surveillance rate. Active retrospective return call were more helpful in obtaining survival information. Programmed follow-up was used in clinical trial. Community-hospital combined model was a new way of surveillance for cancer survivor from which doctor can get more details about cancer survivor and also is helpful for their patients. Conclusion The clinical data management and follow-up models have their specific features and should be applied based on specific situations.