摘要
目的 研究安宁死亡患者一般情况、抢救干预与患者住院终末生存时长、患者生活质量评价的相关性,探讨更优的安宁患者诊疗措施,促进安宁诊疗的规范化.方法 回顾性分析某院2021年1月1日至2022年6月30日安宁死亡患者病历,根据患者主要诊断分为肿瘤组和非肿瘤组,住院期间使用人血白蛋白、死亡前抢救、镇静镇痛等措施,对比两组在住院终末生存时长与患者临终前生活质量.结果 共纳入142例安宁死亡患者分析,中位年龄76(9～97)岁,两组在住院期间使用人血白蛋白、镇静镇痛药物、死亡前抢救,以及终末住院生存时长上差异有统计学意义(P<0.01),在临终前生活质量评分差异无统计学意义(P=0.806 61).结论 安宁患者诊疗具有一定的特殊性,医疗机构收治此类患者应区分晚期肿瘤及非肿瘤患者,根据患者病情、患者及家属的临终前需求使用人血白蛋白、镇静镇痛药物和死亡前抢救,虽能有效延长肿瘤患者的生存时间,但不能改变两组患者临终前生活质量.
Abstract
Objective To study the correlation between the general condition of patients with hospice death and rescue inter-vention,and the survival length of end stage of patients'hospitalization and evaluation of patients'quality of life,to explore better diag-nosis and treatment measures for patients with hospice,and to improve the standardization of diagnosis and treatment for hospice pa-tients.Methods The medical records of patients who died in hospice from January 1,2021 to June 30,2022 were retrospectively an-alyzed,and the patients were divided into tumor group(A)and non-tumor group(F)according to their main diagnosis.Human albu-min,pre-mortem resuscitation,and sedation and analgesia were applied during patients'hospitalization.The survival length of end stage of patients'hospitalization and patients'quality of life of the two groups were compared.Results A total of 142 patients with hos-pice death were included in the analysis,with a median age of 76(9-97),with application of human albumin,pre-mortem resus-citation,and sedation and analgesia,and the difference between the two groups was statistically significant in the survival length of end stage of patients'hospitalization(P<0.01),but there was no significant difference in the quality of life score before death(P=0.806 61).Conclusion The diagnosis and treatment of hospice patients has certain specificity,and medical institutions need to dis-tinguish the indications for advanced tumor and non-tumor hospice patients,and formulate standardized and personalized diagnosis and treatment plans for these two types of patients,so as to achieve the results that patients,medical institutions and society are all satisfied.
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