Leibovitz A, Habot B, Walach N, Gil I
Geriatric Medical Center, Shmuel Harofeh Hospital, Beer Yaakov.
Harefuah. 1996 Sep;131(5-6):156-60, 216, 215.
Cancer is an age-associated disease, and 55% of newly diagnosed cases and 67% of cancer deaths are in those above 65 years. There has recently been increasing interest in geriatric oncology, and more of the elderly are being screened for early cancer detection. Elderly cancer patients present problems not only because of their primary disease, but also because of comorbidity, reduced functional reserve, and diminished social support. Because of this combination of factors many of them need the specially skilled nursing care available in special units. 304 elderly cancer patients were admitted to our "skilled nursing division" of 156 beds during the 6 years 1987-1992. They represented 16% of all admissions and their average age was 78 +/- 0.4 (SD). Mean survival after admission was 4.1 +/- 0.4 months. In the 143 men it was 3.1 +/- 0.4 months and in the 161 women, significantly longer, 4.9 +/- 0.5. The most common location in men was colorectal (22.6%), followed by prostate (16%), while in women it was breast (25.4%), followed by colorectal (16.0%). The longest survival was for women with breast cancer (9.1 +/- 1.3 months) and the shortest for women with gastric cancer (1.9 +/- 0.6). On admission 81% had more than 1 comorbid condition: 91% had restricted mobility, 215 urinary incontinence and 12% various kinds of stomas. Serious conditions were urinary tract infections in 40%, sepsis 20%, pneumonia 12%, gastrointestinal bleeding 10% and bedsores in 7%. 77% needed intravenous fluids and/or drugs for infections, 50% narcotics for analgesia, 27% nasogastric tubes, 20% blood transfusions, 6% debridement, and 5% paracentesis. The elderly with cancer are the most difficult long term patients to treat, since their conditions are dynamic, continuously deteriorating, and they require intensive medical, nursing and psychological care.
癌症是一种与年龄相关的疾病，55%的新诊断病例和67%的癌症死亡发生在65岁以上的人群中。近年来，老年肿瘤学越来越受到关注，越来越多的老年人接受早期癌症筛查。老年癌症患者不仅因其原发性疾病存在问题，还因其合并症、功能储备降低和社会支持减少而面临困难。由于这些因素的综合作用，他们中的许多人需要特殊病房提供的专业护理。在1987年至1992年的6年中，304名老年癌症患者住进了我们拥有156张床位的“专业护理病房”。他们占所有住院患者的16%，平均年龄为78±0.4（标准差）。入院后的平均生存期为4.1±0.4个月。143名男性患者的生存期为3.1±0.4个月，161名女性患者的生存期明显更长，为4.9±0.5个月。男性中最常见的发病部位是结肠直肠（22.6%），其次是前列腺（16%），而女性中最常见的是乳腺（25.4%），其次是结肠直肠（16.0%）。生存期最长的是乳腺癌女性患者（9.1±1.3个月），最短的是胃癌女性患者（1.9±0.6个月）。入院时，81%的患者有不止一种合并症：91%行动受限，21%尿失禁，12%有各种造口。严重情况包括40%的尿路感染、20%的败血症、12%的肺炎、10%的胃肠道出血和7%的压疮。77%的患者因感染需要静脉输液和/或药物治疗，50%的患者需要使用麻醉剂止痛，27%的患者需要鼻胃管，20%的患者需要输血，6%的患者需要清创，5%的患者需要腹腔穿刺。老年癌症患者是最难长期治疗的患者，因为他们的病情动态变化，持续恶化，需要强化的医疗、护理和心理护理。
