生命末期癌症患者难治性痛苦的姑息性镇静

摘要

Objective To survey the palliative sedation (PS) therapy for cancer patients in end-of-life with intractable excruciation and provide the supports of clinical technique.Methods Three hundred and forty-seven patients with cancer in end-of-life were investigated,who were divided into two groups,according to whether receive the PS treatment.Patients' demographic,clinical characteristics,surviving duration,types of medication and dosage were recorded.Results No difference was found in gender,age and kind of diseases between the two groups (P＞ 0.05).The common indications for PS were intractable pain (96.3％),delirium (82.7％) and so on.The mean daily dosage of midazolam was 20 mg.The days of hospital stay was significantly longer in the PS group (18 d) than that in the no PS group (8 d) (P ＜ 0.05).Conclusion The PS treatment is used safely and effectively to treat the intractable excruciation in dying cancer patients,and PS does not shorten life expectation.%目的 研究癌症末期患者难治性痛苦的姑息性镇静(PS),为临床应用提供技术支持.方法 调查癌症末期患者347例作为研究对象;根据是否行PS治疗分成两个组,行PS者采用五级阶梯镇静方法;记录患者一般资料、临床特征与生存期、药物种类和剂量.结果 两组患者性别构成比、年龄、病程等一般资料差异无统计学意义(P＞0.05).PS常见指证是难治性疼痛(96.3％)、谵妄(82.7％)等,常用的咪达唑仑每日平均剂量为20 mg.PS治疗组患者平均住院时间18d,较未接受组(8 d)长,差异有统计学意义(P＜0.05).结论 癌症末期患者应用PS治疗难治性痛苦是安全和有效的,且PS不会缩短生存期.