2007-2016年湖南中医药大学第一附属医院肿瘤科死亡病例分析

摘要

目的 分析湖南中医药大学第一附属医院(以下简称"本院")2007-2016年肿瘤科住院患者死亡病例,为恶性肿瘤防治、改善预后及中医药卫生资源的合理配置提供依据.方法 采用回顾性分析方法,对2007-2016年本院肿瘤科住院患者死亡病例的死因、住院费用及生存期进行分析.结果 2007-2016年,本院肿瘤科住院死亡病例830例,其中男性548例,女性282例,病死率逐年下降.患者平均住院费39630.86元,其中中医药年均治疗费为6206.98元(15.66%).结肠癌患者中医药治疗费用比例最高(20.10%),其次为肺癌、乳腺癌、肝癌.死因排序前5位依次为肺癌、肝癌、乳腺癌、结肠癌、直肠癌.因肺癌死亡的患者男女比例为1.61:1.男性患者平均生存期为446.3 d,远低于女性患者的738.3 d.生存期较长的恶性肿瘤为子宫颈癌、乳腺癌、直肠癌,生存期较短的为胰腺癌、肝癌、肺癌.结论 本院肿瘤科死亡病例的死因构成具有一定代表性.临床中加强肺癌尤其是男性肺癌患者的预防和控制,合理利用中医药卫生资源与防治手段,改善肝癌患者预后,提高乳腺癌、宫颈癌等患者的生存期及生活质量,对恶性肿瘤防治与预后具有重要意义.%Objective To analyze the death cases of the oncology inpatients of the First Hospital of Hunan University of Chinese Medicine (hereinafter referred to as "this hospital") during 2007-2016; To provide the basis for the prevention and treatment of cancer, prognosis improvement and rational allocation of TCM health resources. Methods The death cases of the oncology inpatients from 2007 to 2016 were analyzed by retrospective medical history method from the aspects of causes of death, hospitalization costs and survival time. Results There were 830 death cases of the oncology inpatients in the hospital during 2007-2016, with 548 males and 282 females, and the mortality rate decreased year by year. The average hospitalization costs for patients was 39 630.86 yuan, of which TCM treatment cost 6206.98 yuan (15.66%). Patients with colon cancer had the highest proportion of TCM treatment costs (20.10%), followed by lung cancer, breast cancer, and liver cancer. The top five causes of death were lung cancer, liver cancer, breast cancer, colon cancer, and rectal cancer. The sex ratio of patients who died of lung cancer was 1.61:1. The average survival time of male patients was 446.3 days, which was far lower than the 738.3 days of female patients. The cancers with long-term survival periods were cervical cancer, breast cancer, and rectal cancer. The cancers with shorter survival periods were pancreatic cancer, liver cancer, and lung cancer. Conclusion The structure of death causes of the oncology inpatients in the hospital has a certain degree of representation. The prevention and control of lung cancer, especially male lung cancer should be strengthened; TCM health resources and prevention should be utilized rationally; the prognosis of patients with liver cancer should be improved, to improve the overall survival and quality of life of patients with breast cancer or cervical cancer, which is important for the prevention and treatment of malignant tumor.