新型冠状病毒肺炎疫情对我国结直肠癌患者综合治疗的影响:一项横断面研究

Effects on the integrated treatment of colorectal cancer patients during COVID-19 epidemic in China:a cross-sectional study

目的在新型冠状病毒肺炎(新冠肺炎)疫情防控期间,恶性肿瘤患者的正常诊疗过程受到严重影响。本文调查中国结直肠癌患者在新冠肺炎疫情期间治疗情况及受影响程度,为医护人员制定更精准的医疗决策提供依据。方法运用横断面研究方法,采取便利抽样方法在全国范围内对结直肠癌患者进行问卷调查,收集其基本信息和在新冠肺炎疫情期间的治疗信息,并了解其在疫情期间护理、精神心理、社会支持等方面的影响程度和需求情况。结果共1147例结直肠癌患者纳入研究,其中男性635例(55.4%),女性512例(44.6%),年龄(52.8±12.8)岁。78.1%(896/1147)的结直肠癌患者表示他们的治疗或复查过程受到影响。253例(22.1%)治疗方案被迫更换,其中推迟或更换化疗方案者141例(12.3%);共有83例(7.2%)手术治疗受到影响,有39例(3.4%)进行了急诊手术。有277例(24.1%)的院外护理需求受到影响,最主要是外周静脉植入中心静脉导管维护问题(49.5%,137/277)。疫情期间与疫情前相比,患者睡眠质量更差,苦恼、焦虑、抑郁和愤怒等情绪均比疫情前严重,并且更需要得到帮助(均P<0.001)。有376例(32.8%)进行过远程医疗服务,但其中仅有36.4%(137/376)对远程医疗表示满意。结论新冠肺炎疫情对结直肠癌患者的影响是多方面的,包括诊断、治疗、复查及预后等。尽管远程医疗的出现缓解了一部分就诊压力,但是仍需改进和加强。医务工作者在保护结直肠癌患者避免感染新冠肺炎的同时,也要积极帮助他们及时接受规范治疗,并关注其疫情期间的护理、营养、精神心理及社会支持等需求。

Objective To understand the treatment status and effects on colorectal cancer(CRC)patients in China during the COVID-19 pandemic,and provide evidence for decision-making for health-care workers.Methods The method of cross-sectional study was applied.A questionnaire survey of CRC patients in China was carried out.Their basic and treatment information during the COVID-19 were collected and associated effects on treatment,nursing,state of psychology and needs of social support were analyzed.Results Of the 1147 participants in the study,635(55.4%)were male and 512(44.6%)were female with mean age of(52.8±12.8)years.The treatment or follow up of 896(78.1%)CRC patients were affected during the COVID-19 outbreak.A total of 253 patients(22.1%)had their treatment regiments changed,of whom 141(12.3%)had their chemotherapy regiments postponed or changed,and 83 patients(7.2%)had their surgical treatment affected.Among the above 83 patients,39 patients(3.4%)underwent emergency surgery.A total of 277 patients(24.1%)had their out-of-hospital care needs affected,mainly due to maintenance of PICC(49.5%,137/277).CRC patients had poorer sleep quality and increased levels of insomnia than before(P<0.001),and were more distressed,anxious,depressed,and angry than they were before.They presented the more requirements of help(P<0.001).In addition,376 patients(32.8%)had received telemedicine services,but only 36.4%(137/376)of them were satisfied.Conclusions The COVID-19 epidemic has effect on the integrated treatment of CRC patients include diagnosis,treatment,examination and prognosis.While protecting CRC patients from being infected with SARS-CoV-2,health-care workers should also actively help them to receive timely and correct treatment and pay attention to their nursing,nutritional,psychological and social support needs in the COVID-19 epidemic.