高龄患者原发性肝癌的循证治疗

Therapy strategy of evidence-based practice for the aged patient with primary liver cancer

目的:借助循证医学的方法为高龄患者原发性肝癌确定治疗目标及治疗方案。方法:在充分评估患者病情的基础上根据PICO原则构建临床问题,采用EBM五步法确定检索策略。检索Embase、Cochrane library、Pub Med、CHKD、万方数据库,检索时间截至2014年9月。查找与高龄原发性肝癌患者治疗相关的系统评价/Meta分析、随机对照试验,对所获证据进行评价,并结合患者家属意愿制定治疗方案。结果:共检出并筛选出与原发性肝癌相关的随机对照试验7篇,系统评价/Meta分析4篇,通过对检索结果进行分析,为患者制定合理的治疗方案,经1年随访证实该方案对患者有满意的疗效。结论:采用循证治疗方法,为原发性肝癌高龄患者制定合理治疗方案,可取得满意的效果。

Objective： To formulate an evidence- based treatment plan for the aged patient with primary carcinoma of the liver. Methods： The search strategy was determined by EBM. Based on the PICO principle,the clinical problems were put forward after full evaluation of patients ＇ conditions. We searched the Embase（ 1990- 2014）,Cochrane library（ Issue 9,2014）,Pub Med（ 1980- 2014）,CHKD and CNKI periodical database to identify systematic reviews（ SRs）,randomized controlled trails（ RCTs） involving the treatment for the aged patient with primary carcinoma of the liver. All the collected evidence was critically assessed. Patient preferences was also taken into consideration in the decision- making treatment. Results： A total of 7 RCTs,4 systematic reviews / Meta- analyses were identified.A rational treatment plan was made upon a serious evaluation of the data and the opinion of the patient. After one year of follow- up,the plan was proved optimal. Conclusion： The treatment plan according to evidence- based method for the aged patient with primary carcinoma of the liver can effectively improve the therapeutic efficacy.