癌症紧急姑息治疗：焦虑与咪达唑仑

Emergency palliative cancer care: anxiety and midazolam.

作者信息

Tranung Morten, Solheim Tora S, Løhre Erik Torbjørn, Thronaes Morten, Larsen Michael Due

机构信息

Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.

Department of Clinical Pharmacy - Trondheim Hospital Pharmacy, Trondheim, Norway.

出版信息

BMC Palliat Care. 2025 Mar 13;24(1):64. doi: 10.1186/s12904-025-01687-5.

DOI:10.1186/s12904-025-01687-5

PMID:40082892

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11905623/

Abstract

BACKGROUND AND OBJECTIVE

Cancer patients treated with palliative intent often report anxiety. Anxiety is associated with dyspnoea, cancer pain, and reduced quality of life. Limited knowledge on variability and treatment effects warranted exploring factors associated with improvement in anxiety for hospitalised palliative cancer patients.

METHODS

This study is a cross-sectional secondary analysis. All patients admitted to an acute palliative care unit for one year were assessed and 164 patients satisfied the study inclusion criteria. The patients reported self-registered symptom intensities using the 11-point numeric rating scale. Demographic variables, patient reports, and medical management were analysed for associations with anxiety.

RESULTS

At admission, 37.8% of the patients reported moderate or severe anxiety, and of these 43.6% used benzodiazepines. The corresponding numbers for benzodiazepine use were 35.1% and 24.4% for patients with mild and no anxiety, respectively. Of all patients, 26.8% reported improved anxiety during their hospital stay. More patients with moderate or severe anxiety at admission reported improved anxiety during hospitalisation (50.0%) compared to the corresponding patients with mild anxiety (22.8%). Patients with moderate or severe anxiety reported less improvement in pain compared to patients with mild anxiety. Improved dyspnoea was the only factor statistically associated with improvement in anxiety, both for patients reporting mild anxiety and moderate and severe anxiety. Thirty-seven-point-1% of patients with moderate or severe anxiety at admission received no benzodiazepine treatment during the hospital stay. Patients receiving midazolam had more anxiety at admission, were younger, and had poorer performance status. Median dose and interquartile range [IQR] of midazolam in these patients were 2 mg/24 h [IQR: 2.0-6.0].

CONCLUSION

Improved dyspnoea was associated with reduced anxiety; however, the use of benzodiazepines was not.

摘要

背景与目的

接受姑息治疗的癌症患者常报告有焦虑情绪。焦虑与呼吸困难、癌痛及生活质量下降相关。关于焦虑的变异性和治疗效果的知识有限，因此有必要探索与住院姑息治疗癌症患者焦虑改善相关的因素。

方法

本研究为横断面二次分析。对入住急性姑息治疗病房一年的所有患者进行评估，164例患者符合研究纳入标准。患者使用11点数字评定量表报告自我记录的症状强度。分析人口统计学变量、患者报告和医疗管理与焦虑的相关性。

结果

入院时，37.8%的患者报告有中度或重度焦虑，其中43.6%使用苯二氮䓬类药物。轻度焦虑和无焦虑患者使用苯二氮䓬类药物的相应比例分别为35.1%和24.4%。所有患者中，26.8%报告住院期间焦虑有所改善。入院时中度或重度焦虑的患者中，报告住院期间焦虑改善的比例（50.0%）高于轻度焦虑的相应患者（22.8%）。与轻度焦虑患者相比，中度或重度焦虑患者报告疼痛改善较少。呼吸困难改善是与焦虑改善在统计学上相关的唯一因素，无论是报告轻度焦虑还是中度和重度焦虑的患者。入院时中度或重度焦虑的患者中，37.1%在住院期间未接受苯二氮䓬类药物治疗。接受咪达唑仑治疗的患者入院时焦虑程度更高、年龄更小且功能状态更差。这些患者咪达唑仑的中位剂量和四分位间距[IQR]为2mg/24小时[IQR：2.0 - 6.0]。