CAJ | 학술논문

目的：对我院近4年收治的住院老年恶性肿瘤死亡患者的病案资料进行回顾性调查和统计分析，探讨老年恶性肿瘤死亡分布的特征、死亡原因等，以提供临床医生制定相应的防治措施依据。方法从2009年1月～2012年12月收住我院的病案数据库中收集＞60岁老年恶性肿瘤死亡患者的资料，根据ICD-10进行死因分类并流行病学分析，计算年病死率、分析研究其年龄分布、性别与病种的分布、合并症情况、死亡月份的分布、死亡原因。结果随着年龄的增加，病死率逐渐增加，在70～80岁年龄组达到高峰；60～70岁年龄组随着时间的推移，逐年死亡发生率下降，而70岁以上年龄组则发生率逐年增加；前五位的病种依次为：肺癌、肝癌、大肠癌、胃癌、头颈部癌。在男性，前五位的病种依次为：肺癌、胃癌、大肠癌、肝癌、头颈部癌；在女性，前五位的病种依次为：肝癌、大肠癌、胃癌、头颈部癌、胰胆管癌。大多病种死亡人数男性多于女性；合并症大多为老年性痴呆、脑萎缩、心血管病、糖尿病、前列腺增生、肺部感染；死亡月份的分布显波浪状曲线，2月份达到第一个高峰，8月份达到第二个高峰；主要死于全身多器官衰竭、呼吸衰竭、消化道出血、肝性脑病、肠梗阻。结论对老年恶性肿瘤住院患者的病情及各种影响因素应进行充分的评估，采用有效的综合防治措施，以使患者得到改善症状，提高生存质量，延长生存期。
목적：대아원근4년수치적주원노년악성종류사망환자적병안자료진행회고성조사화통계분석，탐토노년악성종류사망분포적특정、사망원인등，이제공림상의생제정상응적방치조시의거。방법종2009년1월～2012년12월수주아원적병안수거고중수집＞60세노년악성종류사망환자적자료，근거ICD-10진행사인분류병류행병학분석，계산년병사솔、분석연구기년령분포、성별여병충적분포、합병증정황、사망월빈적분포、사망원인。결과수착년령적증가，병사솔축점증가，재70～80세년령조체도고봉；60～70세년령조수착시간적추이，축년사망발생솔하강，이70세이상년령조칙발생솔축년증가；전오위적병충의차위：폐암、간암、대장암、위암、두경부암。재남성，전오위적병충의차위：폐암、위암、대장암、간암、두경부암；재녀성，전오위적병충의차위：간암、대장암、위암、두경부암、이담관암。대다병충사망인수남성다우녀성；합병증대다위노년성치태、뇌위축、심혈관병、당뇨병、전렬선증생、폐부감염；사망월빈적분포현파랑상곡선，2월빈체도제일개고봉，8월빈체도제이개고봉；주요사우전신다기관쇠갈、호흡쇠갈、소화도출혈、간성뇌병、장경조。결론대노년악성종류주원환자적병정급각충영향인소응진행충분적평고，채용유효적종합방치조시，이사환자득도개선증상，제고생존질량，연장생존기。
Objective To retrospectively study the patients'clinical characteristics,annual and monthly mortality rates and the causes of death of geriatric oncology patients who were expired in Xiamen First Hospital during the last four years so that we can provide clinicians some useful information to modify their clinical practice and improve patient care. Methods We examined the hospital inpatient database from January 2009 to December 2012 for all patients with a cancer diagnosis who were older than 60 year and expired during the hospitalization. These patients were classified according to ICD10 cause of death classification and then statistically analyzed the annual and monthly mortality rates,age,gender,primary cancers, comorbid conditions and causes of death. Results Our study showed that the mortality rates increased with age,highest mortality group is the 7o to 80 age group.The annual mortality rates had decreased for the group of age 60 to 70. But for 70 and older group,the annual mortality rates had been increasing. The five most common malignancies were the cancers of lung,liver,colon,stomach and head and neck.For men, the five most common cancers are lung cancer,stomach cancer,colon cancer,liver cancer and head and neck cancer, while for women,they were liver cancer,colon cancer,stomach cancer,head and neck cancer,and pancreatic and cholangiocarcinoma.The male mortality was higher than female.The common comorbid conditions were Alzheimer’s disease,brain atrophy,cardiovascular diseases,diabetes,benign prostate hypertrophy, and pneumonia. There were two peaks in the wave shape monthly mortality curve,the first one was in February and the 2nd peak was in August.The main causes of death were multiple organ failure,respiratory failure, gastrointestinal bleeding,hepatic encephalopathy,and bowel obstruction. Conclusion we have identified the most common malignancies,comorbid conditions and causes of death of geriatric oncology patients who expired in our hospital,which are important for clinicians to design and implement appropriate and effective measurements to improve symptom control,quality of life and survival of these patients.