【摘要】 目的 了解姑息治疗的现状及医务人员对姑息治疗的态度,以推动此项工作的开展。方法 采用问卷调查法对姑息治疗有关的六个方面进行调查。结果 428名被调查者来自全国22个省市自治区的44家医院,其中住院医师占34.6％,主治医师占34.6％,副主任医师占21.0％,护士占10.0％。肿瘤内科专业占大部分(66.4％)。绝大多数医院收治的Ⅲ～Ⅳ期患者占40％以上,其中半数医院甚至达80％以上。大部分患者治疗的目的是积极抗肿瘤治疗和控制症状,平均住院时间在两周至两个月内,部分肿瘤专科医院能够提供临终关怀的有关服务,对便秘、疼痛、中性粒细胞下降控制能力较强,而对厌食、抑郁或焦虑、气短控制则较为困难。城市患者(90％)更多的愿意在医院渡过生命的最后时光,而农村患者(95％)则相反,更多的愿意在家中。半数多的人(51.6％)认为对生存期只有几个月的患者的治疗意见应以姑息治疗为主,但也有近一半的人(46.5％)认为应尽量将延长生命和姑息治疗相结合。三分之一的人认为只有约50％的患者有对临终前不抢救的要求,对是否抢救的观点,多半(60.2％)的医务人员未发表意见。而对不抢救应与患者商量多数表示同意。四分之一的人曾经使用安慰剂治疗疼痛,并且多数人听说过安慰剂治疗疼痛。三分之一的人仍将成瘾看成是疼痛治疗的一个?更多还原

【Abstract】 Objective To investigate the current status of palliative care of cancer patients in China and the clinicians’ attitude to palliative care of cancer patients. Methods Questionnaire was adopted to investigate the palliative care in six aspects. Result 428 clinicians from 44 hospitals of 22 provinces were involved. Of them, 148 (34.6%) were visiting doctors, 90(21.7%) were associate chief doctors, 284(66.4%) were physicians. 50.0% of the clinicians involved had ≥ 80% stage Ⅲ-Ⅳ cancer patients out of cancer patients they treated, while 93.7% of all physicians involved had ≥40% stage Ⅲ-Ⅳ cancer patients out of all patients they treated. The aim of 26% of hospitalized patients was to have anticancer treatment, that of 19.6% of these patients was to relieve symptoms and 76.9% had both aims. The symptoms of advanced cancer patients which could be treated by the doctors were: constipation, nausea, vomiting, pain and neutropenia. The symptoms such as shortness of breath, anorexia and depression were relatively difficult to be treated. 49.6% of investigators used 0-10 or 0-100 scale(NRS), while 34.5% used VRS scale. 26.1% of doctors involved used placebo, 64. 2% of doctors have heard about placebo in the treatment of cancer pain, 24.7% of doctors thought that placebo could be used and 72.0% of doctors thought that the use of placebo should consider ethics. 34.7% of doctors thought that addiction is the barrier of pain control. 89 % of doctors thought told the patients about the effectiveness of the drugs and the prevention of side effects. Conclusion To a certain extent this survey reflects Chinese doctors’ current attitude and treatment of advanced cancer patients.更多还原