中医临床研究
中醫臨床研究
중의림상연구
CLINICAL JOURNAL OF CHINESE MEDICINE
2014年
21期
120-123
,共4页
肿瘤患者%放弃治疗
腫瘤患者%放棄治療
종류환자%방기치료
Critically ill cancer patients%Withholding and/or withdrawing treatment
目的：统计重症肿瘤患者放弃治疗的现状，分析放弃治疗决策的影响因素。方法：对2010年1月1日～2011年12月31日入住中山大学肿瘤防治中心ICU接受重症支持治疗并有完整病例资料记录的肿瘤患者进行回顾性研究，收集其相关临床资料并分析放弃治疗的现状及影响因素。结果：纳入研究共有347例次，其中放弃治疗组82例次（23.6%），持续治疗组265例次（76.4%）；经单因素及多因素分析筛出重症肿瘤患者放弃治疗的高危因素为家庭经济困难、人文关怀需求、ICU内合并MODS/MOF和急诊或病危入院。结论：经济条件差、人文传统需求、病情进展及起病危急状态是重症肿瘤患者放弃治疗决策的高危因素，肿瘤患者放弃治疗的决策与我国医疗体制、医疗卫生资源及文化传统等国情有一定关系。
目的：統計重癥腫瘤患者放棄治療的現狀，分析放棄治療決策的影響因素。方法：對2010年1月1日～2011年12月31日入住中山大學腫瘤防治中心ICU接受重癥支持治療併有完整病例資料記錄的腫瘤患者進行迴顧性研究，收集其相關臨床資料併分析放棄治療的現狀及影響因素。結果：納入研究共有347例次，其中放棄治療組82例次（23.6%），持續治療組265例次（76.4%）；經單因素及多因素分析篩齣重癥腫瘤患者放棄治療的高危因素為傢庭經濟睏難、人文關懷需求、ICU內閤併MODS/MOF和急診或病危入院。結論：經濟條件差、人文傳統需求、病情進展及起病危急狀態是重癥腫瘤患者放棄治療決策的高危因素，腫瘤患者放棄治療的決策與我國醫療體製、醫療衛生資源及文化傳統等國情有一定關繫。
목적：통계중증종류환자방기치료적현상，분석방기치료결책적영향인소。방법：대2010년1월1일～2011년12월31일입주중산대학종류방치중심ICU접수중증지지치료병유완정병례자료기록적종류환자진행회고성연구，수집기상관림상자료병분석방기치료적현상급영향인소。결과：납입연구공유347례차，기중방기치료조82례차（23.6%），지속치료조265례차（76.4%）；경단인소급다인소분석사출중증종류환자방기치료적고위인소위가정경제곤난、인문관부수구、ICU내합병MODS/MOF화급진혹병위입원。결론：경제조건차、인문전통수구、병정진전급기병위급상태시중증종류환자방기치료결책적고위인소，종류환자방기치료적결책여아국의료체제、의료위생자원급문화전통등국정유일정관계。
To investigate the clinical factors of the withholding/withdrawing treatment in the critically ill cancer patients. Methods: Clinical records of 347 patients from 2010.1.1 to 2011.12.31 in our Cancer Center were collected and retrospectively analyze. These data were divided into the withholding/withdrawing treatment group and the normal treatment group, then investigate the clinical characters of the withholding/withdrawing treatment in the critically ill cancer patients. Results: 347 cases were investigated in the study, 82 cases (23.6%) chosen to withhold or withdraw treatment, including 64 men and 18 women.265 cases ( 76.4%)to carryon the treatment. Multivariate logistic regression analyses indicated that the poor economic status, care needs, poor admission status and MODS/MOF in ICU were significant predictors for the withholding and/or withdrawing treatment in the critically ill cancer patients. Conclusion: The poor economic status, care needs, progression of the disease and poor admission status were considered as the main risk factors of the withholding and/or withdrawing treatment in the critically ill cancer patients. Decisionsabout the withholding and/or withdrawing treatment in the critically ill cancer patients have something with our national actual conditions, for example Chinese health care system, health care resources and our cultural custom.
