国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2009年
9期
46-48
,共3页
食管癌%临床路径%结果评价(卫生保健)
食管癌%臨床路徑%結果評價(衛生保健)
식관암%림상로경%결과평개(위생보건)
Esophageal carcinoma%Clinical pathway%Outcome assessment (health care)
目的 评价临床路径在食管癌放化疗中的实施效果.方法 采用非同期队列研究比较实施临床路径前与实施临床路径后两组患者的相关情况.路径共三个,评价指标包括:①治疗适应症;②放疗方式;③放疗剂量;④顺应性;⑤放化疗反应.结果 研究组治疗适应症把握严格,治疗相对规范;放疗方式中常规放疗占42%,常规+适形占17%,全程适形占41%;剂量50～60Gy,平均为52.3Gy;顺应性较好;放化疗反应血象和放射性食管炎与对照组相似(X2=1.22,P>0.05和X2=0.589,P>0.05),但放疗后气促较对照组明显降低(X2=8.241,P<0.05),差异有显著性意义.对照组治疗适应症把握不严,治疗欠规范;放疗方式中常规放疗占85%,常规+适形占6%,全程适形占9%;放疗剂量随意性较大,46～70Gy,平均为67.5Gy;顺应性差.结论 实施食管癌临床路径能够规范治疗,降低毒副作用,提高医疗质量,值得临床进一步推广应用.
目的 評價臨床路徑在食管癌放化療中的實施效果.方法 採用非同期隊列研究比較實施臨床路徑前與實施臨床路徑後兩組患者的相關情況.路徑共三箇,評價指標包括:①治療適應癥;②放療方式;③放療劑量;④順應性;⑤放化療反應.結果 研究組治療適應癥把握嚴格,治療相對規範;放療方式中常規放療佔42%,常規+適形佔17%,全程適形佔41%;劑量50～60Gy,平均為52.3Gy;順應性較好;放化療反應血象和放射性食管炎與對照組相似(X2=1.22,P>0.05和X2=0.589,P>0.05),但放療後氣促較對照組明顯降低(X2=8.241,P<0.05),差異有顯著性意義.對照組治療適應癥把握不嚴,治療欠規範;放療方式中常規放療佔85%,常規+適形佔6%,全程適形佔9%;放療劑量隨意性較大,46～70Gy,平均為67.5Gy;順應性差.結論 實施食管癌臨床路徑能夠規範治療,降低毒副作用,提高醫療質量,值得臨床進一步推廣應用.
목적 평개림상로경재식관암방화료중적실시효과.방법 채용비동기대렬연구비교실시림상로경전여실시림상로경후량조환자적상관정황.로경공삼개,평개지표포괄:①치료괄응증;②방료방식;③방료제량;④순응성;⑤방화료반응.결과 연구조치료괄응증파악엄격,치료상대규범;방료방식중상규방료점42%,상규+괄형점17%,전정괄형점41%;제량50～60Gy,평균위52.3Gy;순응성교호;방화료반응혈상화방사성식관염여대조조상사(X2=1.22,P>0.05화X2=0.589,P>0.05),단방료후기촉교대조조명현강저(X2=8.241,P<0.05),차이유현저성의의.대조조치료괄응증파악불엄,치료흠규범;방료방식중상규방료점85%,상규+괄형점6%,전정괄형점9%;방료제량수의성교대,46～70Gy,평균위67.5Gy;순응성차.결론 실시식관암림상로경능구규범치료,강저독부작용,제고의료질량,치득림상진일보추엄응용.
Objective To evaluate the effects of the clinical pathway for esophageal carcinoma and provide evidences for further improving the pathway.Methods Prospective cohort study was applied to compare the status between the previous group and the clinical pathway group, for whom the clinical pathway was applied. Evaluation indicators including: (1) indication, (2) radiation mode, (3) radiation dose, (4) compliance, (5)response of radiotherapy and chemotherapy.Results The indications was more stricted and treatment was relatively standardized in the study group than those in the contrast group. The percent of normal radiation in the study group was 42%, normal radiation plus comformal radiation 17%, fully comformal radiation 47% .radiation dose was from 50 to 60 Gy, and the average dose was 52.3 Gy. The compliance was better in the study group than those in the contrast group. There were no significant difference of radiation response and esophagitis in two groups(X2=1.22, P>0.05; X2= 0.589, P>0.05).Shortness of breath on postradiation could be evidencely reduced in the study group, and there were statistical difference between two groups(X2=8.241, P<0.05). The percent of normal radiation in the contrast group was 85%, normal radiation plus comformal radiation 6%, fully comformal radiation 9% .radiation dose was from 46 to 70 Gy, and the average dose was 67.5Gy.Conclusion The application of clinical pathway on patients with esophageal carcinoma can improve the quality of medical care, and it deserves to be used more widely.
