Warnock Clare, Cafferty Christine, Hodson Suzanne, Kirkham Elizabeth, Osguthorpe Charles, Siddall Jan, Walsh Rebecca, Foran Bernadette
SCC Group, Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield, UK.
Int J Palliat Nurs. 2008 Oct;14(10):510-5. doi: 10.12968/ijpn.2008.14.10.31496.
The consequences of malignant spinal cord compression (MSCC) can be devastating. If not detected early, MSCC can result in paralysis and significant bowel and bladder dysfunction that is not improved by treatment. Patients have to cope with sudden and unexpected disability alongside a diagnosis of advanced cancer. A multidisciplinary group was established within a cancer centre to review the care of patients with MSCC. Two linked studies were carried out: a staff questionnaire sent to senior medical staff and all nurses and an audit of documentation. The documentation audit reviewed the notes of 50 patients who had received radiotherapy for MSCC. The symptoms patients presented with on admission and before discharge demonstrated that many experienced significant physical problems as a consequence of developing MSCC. Usually, these symptoms were either unaffected by treatment, or had deteriorated further by the time of their discharge from hospital. The average number of days between admission with MSCC and death was 58.6 days (range 2 to 319 days). The project identified variations in practice in a range of aspects of care and provided clear evidence for the need to develop interventions in relation to specific concerns.
恶性脊髓压迫（MSCC）的后果可能是毁灭性的。如果不及早发现，MSCC可导致瘫痪以及严重的肠道和膀胱功能障碍，且治疗无法改善这些状况。患者在被诊断为晚期癌症的同时，还必须应对突然且意想不到的残疾。一家癌症中心成立了一个多学科小组，以审查MSCC患者的护理情况。开展了两项相关研究：向高级医务人员和所有护士发放员工调查问卷，并对文档进行审核。文档审核查阅了50例接受过MSCC放疗患者的病历。患者入院时和出院前出现的症状表明，许多人因患上MSCC而出现了严重的身体问题。通常，这些症状要么未受治疗影响，要么在出院时进一步恶化。MSCC入院至死亡的平均天数为58.6天（范围为2至319天）。该项目发现了护理各方面实践中的差异，并为针对具体问题制定干预措施的必要性提供了明确证据。
