Cheng Benjamin Hon Wai, Sham Michael Mau Kwong, Chan Kwok Ying, Li Cho Wing, Au Ho Yan
Palliative Medical Unit, Grantham Hospital, 125 Wong Chuk Hang Road, Aberdeen, Hong Kong SAR, China Department of Medicine, Queen Mary Hospital, Pok Fu Lam, Hong Kong SAR, China
Palliative Medical Unit, Grantham Hospital, 125 Wong Chuk Hang Road, Aberdeen, Hong Kong SAR, China.
Am J Hosp Palliat Care. 2015 Mar;32(2):221-5. doi: 10.1177/1049909113512412. Epub 2013 Nov 20.
Dying of hematological oncology patients often take place in respective hematology ward or intensive care unit rather than hospice. With the increased attention to quality palliative care for hematology patients, concerns regarding their level of medical care at end-of-life need to be addressed. We conducted a retrospective review of consecutive hematological oncology patients who succumbed in a palliative unit between July 2012 and August 2013. The primary outcome measure was their level of medical care received, including administration of antibiotics, total parenteral nutrition, blood sampling, GCSF injection and blood products transfusion, during their last seven days of life. During the last seven days of life, 85.7 % of patients had blood sampling and 23.8% of patients received G-CSF injection. Total parenteral nutrition was administered in 14.3% of patients. One-third of patients received transfusion of packed cells and nearly half of them received transfusion of platelet concentrates. Almost 90% of patients received antibiotics during their last week of life. Collaboration between hematology and palliative care has resulted in successful transition of hematologic cancer patients into hospice unit in their terminal phase of illness. However, their level of medical care, even approaching last seven days of life, remained intensive. Proper allocation of medical resources and future research regarding optimal end-of-life care for hematology patients are warranted.
血液肿瘤患者通常在各自的血液科病房或重症监护病房去世，而非临终关怀机构。随着对血液科患者优质姑息治疗的日益关注，有必要解决他们在生命末期的医疗护理水平问题。我们对2012年7月至2013年8月期间在姑息治疗病房死亡的连续性血液肿瘤患者进行了回顾性研究。主要观察指标是他们在生命的最后七天所接受的医疗护理水平，包括抗生素的使用、全胃肠外营养、采血、注射粒细胞集落刺激因子（GCSF）以及输血。在生命的最后七天，85.7%的患者接受了采血，23.8%的患者接受了G-CSF注射。14.3%的患者接受了全胃肠外营养。三分之一的患者接受了红细胞输注，其中近一半接受了血小板浓缩液输注。近90%的患者在生命的最后一周接受了抗生素治疗。血液科与姑息治疗之间的合作已成功地使血液癌症患者在疾病终末期转入临终关怀病房。然而，即使临近生命的最后七天，他们的医疗护理水平仍然很高。有必要合理分配医疗资源，并针对血液科患者的最佳临终关怀开展未来研究。
