泾县医院2015年结肠癌术后辅助化疗方案合理性评价分析

Evaluation and Analysis of The Rationality of Adjuvant Chemotherapy for Colon Cancer Patients in Jingxian Hospital in 2015

目的分析泾县医院结肠癌术后治疗方案的合理性,为进一步规范结肠癌的术后治疗方案提供有益参考。方法筛选164例就诊于泾县医院并行结肠癌术后辅助化疗的病例,分别从化疗方案选择合理性、化疗药物剂量准确性、疗程是否足够、不良反应发生率、不同科室治疗差异性等方面进行归纳统计,在此基础上对结肠癌术后辅助治疗方案合理性进行综合评价,对导致不合理治疗的原因进行总结分析。结果化疗方案选择符合指南推荐125例(76.22%),给药剂量符合指南推荐77例(46.95%),化疗疗程符合指南推荐95例(57.93%),6个月完成既定化疗周期81例(49.39%)。肿瘤化疗科在化疗方案选择合理率、治疗疗程合理率、6个月完成既定化疗周期比例三个统计指标上合理率明显高于非肿瘤化疗科(P<0.01)。表明结肠癌术后辅助化疗不规范现象较为严重,还存在巨大的改进空间。结论结肠癌术后辅助化疗方案应该遵从大规模临床试验结果及相关指南推荐,严格掌握药物剂量、具体用法,足疗程给予化疗、积极预防和治疗化疗相关不良反应、及时评价疗效,避免治疗过度或治疗不足等。尤其在非肿瘤化疗科,医生更应在以上方面加以严格规范,从多方面确保结肠癌术后辅助化疗的安全、有效实施。

Objective To analyze the rationality of postoperative treatment plan of colon cancer in Jingxian Hospital,and provide beneficial reference for further standardizing the postoperative treatment plan of colon cancer.Methods Screening of 164 cases of colon cancer in Jingxian Hospital with postoperative adjuvant chemotherapy,summarized the chemotherapy scheme selection,dose accuracy,treatment sufficiency,the incidence of adverse reactions,different departments treatment comparison,aspects of statistics,on the basis of the comprehensive evaluation of the rationality of adjuvant therapy after colon cancer surgery,the causes of unreasonable treatment were summarized and analyzed.Result 125 cases(76.22%)of chemotherapy scheme selection conforms to the guidelines recommend,77 cases(46.95%)of the dosage in accordance with guidelines recommended,95 cases(57.93%)of chemotherapy treatment course in accordance with guidelines recommend,81 cases(49.39%)finished the cycle of chemotherapy in six months.In the oncology department,the rational rate of chemotherapy plan,the reasonable rate of treatment course,and the completion period chemotherapy were completed in 6 months.The reasonable rate of three statistical indicators was significantly higher than that of the non-oncology department(P<0.01).It shows that the non-standard adjuvant chemotherapy after colon cancer surgery is more serious,and there is still a huge space for improvement.Conclusions Colon cancer postoperative adjuvant chemotherapy scheme should follow large?scale clinical trials and related guidelines recommend,strict control of drug dosage,concrete usage,full course chemotherapy,active prevention and treatment of adverse drug reactions associated with chemotherapy,timely evaluation of curative effect,avoid excessive or insufficient treatment etc.Especially in non-oncology departments,doctors should be strictly standardized in the above aspects,safety and effective implementation of adjuvant chemotherapy for colon cancer patients from multiple perspectives.