对晚期癌症患者开展强化姑息照护的临床应用研究

Clinical study of intensive palliative care for patients with advanced cancer

目的评价强化姑息照护在晚期癌症患者中的应用效果。方法 2015年2月~2016年7月,筛选医院收治的晚期恶性肿瘤姑息治疗患者142例,采用随机数字表达法分组,其对照组、强化照护组各71例,对照组以对症护理、治疗护理、疼痛管理、营养管理为主,强化照护组加强康复护理、心理护理、社会需求护理、灵性护理等护理工作,对比护理质量指标,以及护理前、出院后3个月生活质量评分(FACT-G)。结果强化照护组患者满意率、主要照料人满意率、癌痛缓解率高于对照组,差异有统计学意义(P<0.05),差异无统计学意义(P>0.05);出院后3个月,组内比较观察组社会/家庭状况、情感状况、功能状况、总分高于护理前,组间对比观察组高于对照组,组内对比对照组社会/家庭状况评分低于护理前,差异有统计学意义(P<0.05)。结论强化姑息照护有助于提升晚期癌症患者生命质量,提高患者及其照料人的满意率,而普通护理患者出院后生命质量无明显改善,甚至可能出现倒退。

Objective To evaluate the effectiveness of intensive palliative care in patients with advanced cancer. Methods From February 2015 to July 2016,142 patients were admitted to the hospital with malignant tumor palliative,using random number expression method,control group,intensive care group with 71 cases in each group,the control group with symptomatic nursing,nursing care,pain management,nutrition management,intensive care group to strengthen rehabilitation nursing,psychological nursing,nursing needs of society spiritual care,nursing,nursing and nursing quality indicators comparison before and after discharge,the quality of life（ FACT-G） score of 3 months. Results Intensive care patients satisfaction rate,primary care satisfaction rate,remission rate was higher than the control group,the difference was statistically significant（ P〈0. 05）,two in the group of severe complication rate showed no significant difference（ P〈0. 05）; 3 months after discharge,the observation group within the group social/family status score,emotional status,functional status,higher than those before nursing. The comparison between the two groups was higher than the control group,group compared with the control group,social/family status score lower than before treatment,the difference was statistically significant（ P〈0. 05）. Conclusion intensive palliative care can help improve the quality of life of patients with advanced cancer,improve the satisfaction rate of patients and their caregivers,and improve the quality of life of patients with general care after discharge,and may even regress.