住院患者的心理需要

住院病人是社会中各阶层的不同角色，有着不同的职业，年龄和文化程度，但他们共同的目的是：尽早明确诊断，得到有效的治疗，治好自己的病，同时需要有清洁的环境，舒适的床铺，从而得到充分的休息和睡眠，防止交叉感染，排除各种意外的不安生等因素。     

肿瘤患者住院睡眠质量调查分析及护理对策

目的：调查肿瘤患者在住院期间的睡眠质量,探讨及分析护理干预对肿瘤患者住院睡眠质量的影响。方法采用问卷调查法对200例肿瘤内科住院患者睡眠质量的影响因素进行调查;通过PSQI（匹兹堡睡眠质量指数）评价睡眠质量,分析睡眠不良（PSQI≥7）和睡眠良好（PSQI＜7）的情况;对PSQI≥7的患者进行干预性护理,并观察对睡眠质量的影响。结果睡眠不良者141人,占70．5％,PSOI评分为11．62±2．17,睡眠良好者59人,占29．5％,PSOI评分为3．54±1．16,两组的PSOI评分差异有统计学意义（P＜0．05）。对睡眠不良者采用干预性护理后,患者睡眠均有不同程度改善,PSOI评分为9．41±2．03,与未干预前相比,差异有统计学意义（P＜0．05）。结论焦虑及噪音是影响肿瘤患者住院睡眠质量的主要因素,通过有针对性的护理干预可以改善住院患者睡眠情况,有利于疾病的恢复。     

1324例住院癌症患者近期疗效统计

目的 探讨癌症住院病人的终末医疗质量。方法 对陕西省肿瘤医院1324例出院病历记录，按照国际疾病分类：ICD-9，统计分析住院病人的治愈、好转、未愈、病死率及癌症类型。结果 全年住院超过百例以上的癌症依次为肺癌、食管癌、宫颈癌、胃癌、恶性淋巴瘤、肝癌和乳腺癌，癌症病人的平均治愈率为19．34％，好转率为60．20％，未愈率为14．5％，病死率为5．96％。结论 由于受多因素影响，癌症的治疗效果还不如人意，要提高治愈率，降低病死率仍需继续努力。     

谁偷走了癌症患者的睡眠

癌症患者的睡眠质量与焦虑、抑郁、疲乏、疼痛等常见症状存在着交互作用,影响患者白天的清醒水平、功能状态、免疫水平,并最终导致患者生命质量的下降。疼痛是癌症患者常见的症状之一,如今普遍认为疼痛会导致睡眠障碍的发生与持续,而睡眠的缺     

住院肿瘤患者的健康教育

健康教育是指通过有计划、有组织、有系统的教育活动，促使人们自愿采用有利于健康的行为和生活方式，促进健康，提高生存质量。随着人们生活水平的提高，疾病谱的改变，恶性肿瘤有明显增多趋势，主要与人们的生活方式、心理、社会、环境等因素……     

肿瘤患者住院放疗期间影响睡眠质量因素的调查分析

目的:了解肿瘤患者住院放疗期间睡眠质量变化及影响睡眠质量的主要因素.方法:采用我们自行设计的影响睡眠质量因素的调查表,对152例肿瘤患者住院放疗期间睡眠情况进行问卷调查.结果:152例肿瘤患者在住院放疗期间睡眠质量有不同程度改变,睡眠质量改变≤4分的占138例(90.79%);影响睡眠质量的因素依次为:病理因素引起身体不适、担心病情发展、治疗愈后情况、放疗副反应、夜间护理活动影响休息、环境噪音影响、相邻病床问影响等.结论:肿瘤患者住院放疗期间睡眠质量有不同程度下降,医护人员应高度重视,及早采取针对性预防措施.     

晚期肿瘤患者睡眠质量及其相关影响因素的调查分析

目的 探讨晚期肿瘤患者的睡眠质量情况及其相关影响因素.方法 采用自制量表调查患者一般情况、营养状况、运动状况及治疗情况,采用匹兹堡睡眠质量指数(PSQI)调查患者睡眠质量,评价患者睡眠质量总分及各分项得分情况采用t检验,睡眠质量异常发病率分析采用秩和检验,对影响睡眠质量的多因素分析采用有序Logistic回归分析及相关...     

2236例超长住院患者住院时间的影响因素分析

[目的]了解超长住院日形成原因,为医疗管理部门有效缩短平均住院日提供参考依据.[方法]收集2015年1月1日至2015年6月30日医疗统计系统资料,对超长住院患者(住院时间≥30天)进行统计分析.[结果]超长住院患者主要集中在40～59岁(52.99％)和60～79岁(36.23％),主要病种是肺恶性肿瘤(18.16％)、乳腺恶性肿瘤(18.11％)和宫颈恶性肿瘤(16.19％).治疗方式是影响超长住院时间的独立危险因素.[结论]规范诊疗行为、优化住院诊疗和服务流程、加强围手术期管理是减少住院时间的重要途径.     

老年住院患者死因分析

目的：了解老年住院患者的主要死因。方法：对我院1990年1月－2001年10月死亡的60岁以上的全部住院患者的病历进行死亡原因分析，结果：死亡顺位依次为：恶性肿瘤、呼吸系统疾病、心、脑血管病，消化系病，肾脏病，休克，外伤，多脏器功能衰竭及血液病。其中，恶性肿瘤，呼吸系统疾病，心血管病、脑血管病占全部死亡病例的82．45％，是前四位的死因，恶性肿瘤占全部死亡病例的37．70％，在恶性肿瘤中肺癌占28．49％， 其次胃癌（21．37％），女性乳癌（11．76％），居第三位的是男性肝癌（14．00％），结论：老年人应定期查体，对恶性肿瘤做到早诊断及早治疗，对老年女性患者尤应注意乳腺癌的防治，注意预防感冒，以减少呼吸道感染的发生，改变不良生活方式。     

Short duration of sleep increases risk of colorectal adenoma

BACKGROUND:

Short duration and poor quality of sleep have been associated with increased risks of obesity, cardiovascular disease, diabetes mellitus, and total mortality. However, few studies have investigated their associations with risk of colorectal neoplasia.

METHODS:

In a screening colonoscopy‐based case‐control study, the Pittsburg Sleep Quality Index (PSQI) was administered to 1240 study participants before colonoscopy.

RESULTS:

Three hundred thirty‐eight (27.3%) of the participants were diagnosed with incident colorectal adenomas. Although there was no appreciable difference in the overall PSQI score between cases and adenoma‐free controls (5.32 vs 5.11; P = .37), the authors found a statistically significant association of colorectal adenoma with the PSQI component 3, which corresponds to sleep duration (P = .02). Cases were more likely to average less than 6 hours of sleep per night (28.9% vs 22.1% in controls, P = .01). In multivariate regression analysis adjusted for age, gender, race, smoking, family history of colorectal cancer, and waist‐to‐hip ratio, individuals averaging less than 6 hours per night had an almost 50% increase in risk of colorectal adenomas (OR = 1.47; CI = 1.05‐2.06, P for trend = .02) as compared with individuals sleeping at least 7 hours per night. Cases were also more likely to report being diagnosed with sleep apnea (9.8% vs 6.5%, P = .05) and more likely to have worked alternate shifts (54.0% vs 46.1%, P = .01), although these differences were not significant in multivariate models.

CONCLUSIONS:

Shorter duration of sleep significantly increases risk of colorectal adenomas. The authors' results suggest sleep duration as a novel risk factor for colorectal neoplasia. Cancer 2011. © 2010 American Cancer Society.     

恶性肿瘤住院患者营养状况与生活质量分析

目的:分析恶性肿瘤住院患者营养状况、生活质量现状及其相关性。方法:选取2018年2月至2018年11月我院入院的1 057例恶性肿瘤患者,采用NRS2002实施营养风险筛查、PG-SGA评估其营养状况、EORTC QLQ-C30调查其生活质量,在患者出院后收集住院期间营养支持情况。结果:1 057例患者中,34.3%存在营养风险,51.8%存在营养不良;营养良好组的白蛋白、血红蛋白、红细胞计数、体重、体质量指数、三头肌皮褶厚度、握力均高于营养不良组（P＜0.05）。营养良好组在总体健康状况及5个功能领域的分数高于营养不良组（P＜0.05）;在9个症状领域的得分低于营养不良组（P＜0.05）;营养状况与总体健康状况及5个功能领域呈负相关（P＜0.05）,与9个症状领域呈正相关（P＜0.05）。肿瘤患者营养支持率低,仅17.69%的患者得到营养支持。结论:恶性肿瘤住院患者营养状况普遍较差,营养不良影响患者生活质量。     

The role of palliative chemotherapy in hospitalized patients

Background

Hospitalized patients with advanced cancer often have a poor performance status, which is considered a relative contraindication to cytotoxic chemotherapy. We investigated outcomes in hospitalized solid tumour oncology patients who received palliative chemotherapy (pct).

Methods

With ethics approval, we performed a single-institution chart review of all patients hospitalized on our oncology unit who received pct between April 2008 and January 2010. Patient demographics, reasons for admission, cancer type, prior therapy, and administered chemotherapy were recorded. The primary endpoint was median survival from date of inpatient chemotherapy until death or last known follow up. We also investigated place of discharge and whether patients received additional therapy.

Results

During the study period, 199 inpatients received pct. Median age was 61 years; 59% of the patients were women. Most had been admitted with dyspnea (31%) or pain (29%) as the dominant symptom. Common cancers represented were breast (23%), small-cell lung cancer (sclc, 22%), non-small-cell lung cancer (nsclc, 16%), and colorectal cancer (9%). Most patients (67%) were receiving first-line chemotherapy. Median overall survival duration was 4.5 months, and the 6-month survival rate was 41%. The longest and shortest survivals were seen in the sclc and nsclc groups (7.3 and 2.5 months respectively). Factors significantly associated with shorter survival were baseline hypoalbuminemia and therapy beyond the first line. In this cohort, 77% of patients were discharged home, and 72% received further chemotherapy.

Conclusions

Despite a short median survival, many patients are well enough to be discharged home and to receive further chemotherapy. The development of risk models to predict a higher chance of efficacy will have practical clinical utility.     

Association of sleep duration,sleep apnea,and shift work with risk of colorectal neoplasms: a systematic review and meta-analysis

BackgroundAlthough studies have reported that certain sleep characteristics, such as sleep duration and sleep apnea, are linked to the risk of colorectal cancer (CRC), this link remains contentious because of the limited evidence from individual studies. Furthermore, evidence indicated that shift work involving circadian disruption as a probable human carcinogen. This systematic review and meta-analysis aimed to examine the associations between sleep duration, sleep apnea, and shift work with the risk of colorectal neoplasms, including CRC and colorectal adenoma (CRA).MethodsWe conducted a comprehensive literature search in PubMed, Embase, and Web of Science databases. The inclusion criteria were determined using PICOS principles. Observational studies reporting associations of sleep duration, sleep apnea, or shift work with risk of CRC or CRA were included. We assessed the risk of bias on the basis of the Newcastle–Ottawa Scale.ResultsA total of 18 observational studies were included. Of these studies, nine studies reported the effect of sleep duration on risk of colorectal neoplasms, five reported the effect of sleep apnea, and six reported the effect of shift work. The relative risk (RR) for colorectal neoplasms was 1.06 [95% confidence interval (CI): 0.94, 1.20] in the short sleep duration group compared with the moderate sleep duration group. Long sleep duration was associated with an increased risk of colorectal neoplasms (RR: 1.33, 95% CI: 1.07, 1.65). The pooled results showed that sleep apnea was associated with an increased risk of colorectal neoplasms (RR: 1.75, 95% CI: 1.56, 1.97). Furthermore, results showed that the association between shift work and the risk of colorectal neoplasms was not significant (RR: 1.06, 95% CI: 0.95, 1.17). No publication bias was observed in all the analyses (all P>0.05). The sensitivity analysis showed that no individual study substantially influenced the pooled RRs for colorectal neoplasms and CRC.ConclusionsOur findings suggest the significant positive association of long sleep duration and sleep apnea with risk of colorectal neoplasms and CRC. Given that sleep characteristics may be a potentially modifiable risk factor for colorectal neoplasms, further understanding of its role in carcinogenesis will provide valuable insight for cancer prevention.     

常见恶性肿瘤住院患者营养状况及影响因素分析

目的 研究常见恶性肿瘤住院患者的营养状况及其影响因素。方法 选取2018年1月至2019年12月昆明医科大学第一附属医院病理确诊为恶性肿瘤的1385例患者,记录患者人口学资料,进行人体学测量,并收集患者入院48 h内的生化检验结果,同时采用患者主观整体评估量表（PG-SGA）进行营养状况评估,并分析营养状况的影响因素。结果 1385例恶性肿瘤患者,其中男性980例（70.8%）,女性405例（29.2%）,平均年龄为（56.5±13.4）岁。PG-SGA评分为（6.92±5.27）分,营养良好、可疑/轻度营养不良、中度营养不良、重度营养不良发生比例分别为14.7%(203/1385)、20.1%(279/1385)、31.0%(429/1385)、34.2%(474/1385)。患者在住院期间仅23.0%(319/1385)使用过肠内营养,36.6%(507/1385)使用过肠外营养,同时使用肠内和肠外营养的比例为7.1%(99/1385)。控制相关混杂因素后,多因素Logistic回归分析显示年龄（≥70岁）、男性、肿瘤有转移、近1～3个月体重下降及近1周饮食下降是营养不良发生的危险...     

Evaluation of sleep quality in adolescent patients with osteosarcoma using Pittsburgh Sleep Quality Index

The sleep quality of patients with osteosarcoma (OS) was poorly understood. We aimed to evaluate the prevalence of sleep dysfunction in adolescent patients with OS using the Pittsburgh Sleep Quality Index (PSQI) and to further investigate the psychometric properties of the PSQI in this cohort of patients. Fifty four adolescent patients with OS who underwent chemotherapy treatment in our clinic centre were included. Sleep quality was assessed with the Chinese PSQI. Cronbach's alpha was calculated to evaluate the internal consistency. The confirmatory factor analysis (CFA) was used to determine the fitness of a two‐factor structure. Sleep disturbance was observed in 57.4% (31/54) of the patients. Patients with the presence of metastasis or more than 2 cycles of chemotherapy were found to have remarkably higher median global score. The overall Cronbach's alpha was 0.87. The CFA showed an overall comparative fit index of 0.97, a root mean square error of approximation of 0.06 and a standardised root mean square residual of 0.07 respectively. PSQI was a reliable instrument to evaluate the sleep quality of adolescent patients with OS. Over half of the patients may experience sleep disturbance during the treatment. Early psychological interventions were recommended to improve the sleep quality of the patients.     

四川省肿瘤医院16年恶性肿瘤住院患者死因构成及变化趋势

目的:回顾性分析四川省肿瘤医院16年来恶性肿瘤住院患者主要死因构成及年代变化趋势。方法:回顾性收集四川省肿瘤医院2004年01月至2019年12月收治的恶性肿瘤住院患者及死亡病例,分析恶性肿瘤住院患者的主要死亡原因,性别、年龄分布,死因构成的年代变化以及死亡患者占同期住院患者比例的年代变化。结果:2004年-2019年16年间我院收治恶性肿瘤住院患者总数280 042例,恶性肿瘤死亡5 213例,恶性肿瘤住院患者和恶性肿瘤死亡患者数量呈逐年上升趋势。前10位死因顺位依次为:肺癌(34.5%)、肝癌(9.8%)、食管癌(8.2%)、结直肠癌(7.4%)、胃癌(5.5%)、淋巴瘤(3.9%)、乳腺癌(3.8%)、胰腺癌(3.6%)、前列腺癌(2.5%)和胆囊癌(2.0%),合计占总死亡数的81.2%。男性病死率明显高于女性(2.1% vs 1.6%,P＜0.001)。<40岁、40~49岁、50~59岁和≥60岁4个年龄组恶性肿瘤住院患者的病死率分别为0.8%、1.4%、1.8%、2.8%,随着年龄的增长,恶性肿瘤的病死率呈明显上升趋势(P＜0.001)。肺癌始终是第一大死因,3个年代的构成比逐年上升。食管癌和胃癌的死亡构成比明显下降,而肝癌和结直肠癌的死亡构成比明显上升。恶性肿瘤死亡患者占同期住院患者比例为1.86%。其中2004年恶性肿瘤死亡患者占同期住院患者比例为12.6%,2019年下降至1.4%,随时间呈明显下降趋势(P＜0.001)。结论:恶性肿瘤住院患者逐年增加,死亡患者占同期住院患者的比例逐年下降,肺癌仍是恶性肿瘤第一大死因,食管癌和胃癌的死亡构成比随时间呈下降趋势。     

首次入院的食管癌患者是否选择手术治疗的影响因素

目的:探讨首次入院的食管癌患者是否选择手术治疗的影响因素。方法:选取2014年11月11日至2015年12月23日在西安交通大学第一附属医院住院的食管癌患者,收集并分析患者入院相关信息,包括性别、年龄、住址、入院时间、入院科室、并发疾病、是否有局部转移、是否有远处转移、肿瘤家族史、肿瘤位置、病理类型及分化程度。结果:首次入院科室为外科的手术几率远较非外科的要高(OR=76.998,95%CI:27.614~214.697)。手术患者发现局部淋巴结转移的几率较非手术患者高7倍(OR=7.245,95%CI:2.807~4.099)。如果发现远处转移,则更倾向于选择非手术治疗(OR=0.142,95%CI:0.051~0.4)。非手术患者组有肿瘤家族史的较手术患者组多(OR=0.419,95%CI:0.18~0.972)。结论:有远处转移及肿瘤家族史的患者更倾向于非手术治疗,入住外科的患者更倾向于手术治疗。