2018-2020年上海市高境镇肿瘤患者死亡情况分析

Analysis of death of tumor patients in Gaojing Community,Shanghai from 2018 to 2020

目的:对上海市宝山区高境镇2018—2020年直接死亡原因为肿瘤的居民死亡信息进行分析,为社区卫生服务中心更好地开展安宁疗护工作提供参考。方法:收集死亡时间为2018年1月1日—2020年12月31日、直接死亡原因为肿瘤的上海市宝山区高境镇居民相关信息,将肿瘤患者按死亡地点分为调查组和对照组,对两组患者的相关数据进行分析比较。结果:2018—2020年调查组患者的死亡地点多为家中或养老院/护理院,在社区卫生服务中心死亡的较少,对照组患者的死亡地点多为二、三级医疗机构。2018—2020年调查组患者死亡人数排名前3位的肿瘤分别为肺肿瘤、结直肠肿瘤、胃肿瘤和肝肿瘤,对照组患者死亡人数排名前3位的肿瘤分别为肺肿瘤、结直肠肿瘤、胃肿瘤和肝肿瘤,两组患者排名前3位的肿瘤类型基本一致。2018—2020年两组患者自确诊到死亡的生存时间差异均有统计学意义(P<0.05)。结论:对终末期肿瘤患者而言,医疗费用相对较为低廉的社区卫生服务中心能够缓解其家庭经济压力,安宁疗护病房和居家安宁疗护服务也能有效减轻家属的照护负荷。应在日常肿瘤患者随访中加强社区安宁疗护服务宣教,让更多有需要的肿瘤患者接受和使用安宁疗护服务。

Objective:To analyze the death information of residents whose direct cause of death was tumor in Gaojing Community,Baoshan District,Shanghai from 2018 to 2020,so as to provide reference for community health service centers to better carry out hospice care.Methods:The information about residents who died from January 1,2018 to December 31,2020 in Gaojing Community,Baoshan District,Shanghai and the direct cause of death that was tumor was collected,the tumor patients were divided into an investigation group and a control group according to the place of death,and the relevant data of the two groups were analyzed and compared.Results:From 2018 to 2020,most of the patients in the investigation group died at home or in the elderly houses/nursing homes,there are fewer deaths in the community health service centers,and most of the patients in the control group died in the secondary and tertiary medical institutions.From 2018 to 2020,the top three tumors in the investigation group were lung tumors,colorectal tumors,stomach tumors and liver tumors,and the top three tumors in the control group were lung tumors,colorectal tumors,stomach tumors and liver tumors,and the top 3 tumor types of the two groups were basically the same.There was significant difference in the survival time from diagnosis to death between the two groups from 2018 to 2020(P<0.05).Conclusion:For end-stage tumor patients,community health service centers with relatively low medical expenses can alleviate their family economic pressure,and hospice wards and home hospice services can also effectively reduce the care load of their families.Community hospice care service education should be strengthened in the daily follow-up of cancer patients,so that more tumor patients in need can receive and use hospice care services.