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[东京慈惠会医科大学晚期癌症患者居家姑息治疗的现状]

[The current status of home palliative care for patients with advanced cancer at the Jikei University School of Medicine].

作者信息

Nagasaki Eijiro, Sakuyama Toshikazu, Hayashi Kazumi, Sakaji Yukie, Aoki Masako, Naito Yasuko, Arakawa Yasuhiro, Uwagawa Tadashi, Kobayashi Tadashi, Aiba Keisuke

机构信息

Dept. of Oncology and Hematology,The Jikei University School of Medicine.

出版信息

Gan To Kagaku Ryoho. 2014 Dec;41 Suppl 1:63-5.

Abstract

Medical oncologists are involved in cancer chemotherapy as well as end-of-life care. Recently, an increased number of patients with advanced cancer have expressed their preference to receive palliative care at their home during the end-of-life period, and several home medical care providers have aimed to provide such a service. The number of cancer patients who wish to receive home palliative care has also increased at our institution. We reviewed the characteristics of advanced cancer patients who received chemotherapy and who eventually received homecare from 2012 to 2014. The total number of patients was 22. Of these, 9 had breast cancer(40.9%)and 8 had colorectal cancer(36.4%). The median age was 68(range 36-90) years. Half of these patients died at home. The median duration of homecare to death was 64.5(range 12-252)days. Approximately 70% of patients were able to remain at home for over a month, but 3 patients died within 2 weeks at home and 1 patient returned to the hospital after 10 days of homecare due to disease progression. While palliative care in the home setting is valued by many cancer patients in the end-of-life period, close monitoring is needed for patients with rapidly progressing disease.

摘要

肿瘤内科医生参与癌症化疗以及临终关怀。最近,越来越多的晚期癌症患者表示希望在临终阶段在家中接受姑息治疗,一些家庭医疗服务提供者也致力于提供此类服务。我院希望接受家庭姑息治疗的癌症患者数量也有所增加。我们回顾了2012年至2014年接受化疗并最终接受家庭护理的晚期癌症患者的特征。患者总数为22人。其中,9人患有乳腺癌(40.9%),8人患有结直肠癌(36.4%)。中位年龄为68岁(范围36 - 90岁)。这些患者中有一半在家中死亡。从接受家庭护理到死亡的中位持续时间为64.5天(范围12 - 252天)。约70%的患者能够在家中停留超过一个月,但有3名患者在家中两周内死亡,1名患者在接受家庭护理10天后因疾病进展返回医院。虽然家庭环境中的姑息治疗在许多癌症患者的临终阶段受到重视,但对于疾病进展迅速的患者需要密切监测。

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