CAJ | 학술논문

目的借助循证医学的方法为一例临床罕见卵巢癌术后脾转移患者确定治疗目标和方案.方法充分评估患者情况,提出临床问题,从Cochrane Library、CNKI、万方数据库、PubMed、Embase和ScienceDirect数据库检索相关证据,检索时间截至2009年10月.对所获证据进行评价,并结合医生经验及患者愿望制定治疗方案.结果共检索出英文文献15篇,中文文献11篇.Cochrane数据库内尚无卵巢癌术后脾转移治疗方面的RCT,PubMed、Embase和ScienceDirect数据库含5篇综述类文章,CNKI和万方数据库含回顾性队列研究1篇,其余均为个例报道.综合分析检索结果,为患者制订相对合理方案,经20个月随访,该方案适合.结论本例属罕见病例,虽然循证证据强度偏低,不能充分体现循证治疗的价值,但最终治疗结果满意.本研究可为此类缺乏大型RCT的罕见病例运用循证思维诊治提供参考.
목적 차조순증의학적방법위일례림상한견란소암술후비전이환자학정치료목표화방안.방법 충분평고환자정황,제출림상문제,종Cochrane Library、CNKI、만방수거고、PubMed、Embase화ScienceDirect수거고검색상관증거,검색시간절지2009년10월.대소획증거진행평개,병결합의생경험급환자원망제정치료방안.결과 공검색출영문문헌15편,중문문헌11편.Cochrane수거고내상무란소암술후비전이치료방면적RCT,PubMed、Embase화ScienceDirect수거고함5편종술류문장,CNKI화만방수거고함회고성대렬연구1편,기여균위개례보도.종합분석검색결과,위환자제정상대합리방안,경20개월수방,해방안괄합.결론 본례속한견병례,수연순증증거강도편저,불능충분체현순증치료적개치,단최종치료결과 만의.본연구가위차류결핍대형RCT적한견병례운용순증사유진치제공삼고.
Objective Evidence-based medicine was used to make an individualized treatment plan for rare solitary splenic metastasis of an ovarian carcinoma in a female patient. Methods After clinical problems were discovered, evidence was collected from the Cochrane Library, PubMed, EMBASE, ScienceDirect, CNKI and Wanfang databases according to our predefined search strategy. The search was done until October, 2009. The validity of the evidence was assessed. The evidence, combined with the doctor experience and the patient value, was applied to the patient. Results A total of 15 English literature and 11 Chinese literature were identified. A rational treatment plan was made upon a critical evaluation of the data. There were 5 review articles in PubMed, EMBASE and ScienceDirect databases and no RCT in the Cochrane Library. And there was one retrospective cohort study inCNKI and Wanfang databases. The others were all case reports. After 20 month follow-up, the treatment protocol was proven correct. Conclusion The patient has rare disease, and the evidence intension for the evidence-based medicine was low. It can not present the efficacy of the evidence-based medicine treatment sufficiently, though it could provide some suggestion for rare disease which was lack of large RCT for evidence-based Methods .