姑息性护理在肺癌病人癌因性疲乏的应用进展

介绍姑息性护理和癌因性疲乏的概念,阐述肺癌病人癌因性疲乏的状况,分析癌因性疲乏对肺癌病人的影响,以及姑息性护理在肺癌病人癌因性疲乏中的应用,为国内学者更好地认识和评价姑息性护理及肺癌病人的癌因性疲乏,为不断提高肺癌病人的生活质量作为参考。     

Bleeding in Patients With Gastrointestinal Cancer Compared With Nongastrointestinal Cancer Treated With Apixaban,Rivaroxaban, or Enoxaparin for Acute Venous Thromboembolism

ObjectiveTo compare the bleeding risk in patients with gastrointestinal (GI) cancer with that in patients with non-GI cancer treated with anticoagulation for acute cancer-associated venous thromboembolism (Ca-VTE).Patients and MethodsConsecutive patients with Ca-VTE seen at the Mayo Thrombophilia Clinic between March 1, 2013, and April 20, 2020, were observed prospectively to assess major bleeding and clinically relevant nonmajor bleeding (CRNMB).ResultsIn the group of 1392 patients with Ca-VTE, 499 (35.8%) had GI cancer including 272 with luminal GI cancer (lower GI, 208; upper GI, 64), 176 with pancreatic cancer, and 51 with hepatobiliary cancer. The rate of major bleeding and CRNMB in patients with GI cancer was similar to that in 893 (64.2%) patients with non-GI cancer treated with apixaban, rivaroxaban, or enoxaparin. Apixaban had a higher rate of major bleeding in luminal GI cancer compared with the non-GI cancer group (15.59 vs 3.26 per 100 person-years; P=.004) and compared with enoxaparin in patients with luminal GI cancer (15.59 vs 3.17; P=.04). Apixaban had a lower rate of CRNMB compared with rivaroxaban in patients with GI cancer (3.83 vs 9.40 per 100 person-years; P=.03). Patients treated with rivaroxaban in the luminal GI cancer group had a major bleeding rate similar to that of patients with non-GI cancer (2.04 vs 4.91 per 100 person-years; P=.37).ConclusionApixaban has a higher rate of major bleeding in patients with luminal GI cancer compared with patients with non-GI cancer and compared with enoxaparin in patients with luminal GI cancer. Rivaroxaban shows no increased risk of major bleeding in patients with GI cancer or luminal GI cancer compared with patients with non-GI cancer.Trial RegistrationClinicalTrials.gov identifier: NCT03504007.     

乳腺癌患者心身症状的影响因素探讨

目的比较乳腺癌患者与其他癌症患者心身症状的差异,探讨乳腺癌患者心身症状的影响因素。方法使用SCL-90、MCMQ、EPQ对60例乳腺癌患者及使用SCL-90对127例其他癌症患者进行问卷调查。结果(1)乳腺癌患者与其他癌症患者在心身症状上的差异没有统计意义。(2)乳腺癌患者的心身症状与面对、屈服应对方式呈正相关,与回避应对方式呈负相关,且有统计意义;乳腺癌患者的心身症状还与情绪紧张人格维度呈正相关。结论本研究中乳腺癌患者的心身症状与面对应对方式呈现的正相关与以往面对癌症患者的心身症状呈负相关不相一致,这表明乳腺癌患者的心身症状与应对方式的关系有一定的特殊性。根据乳腺癌病人心身症状的影响因素,护士在护理工作中应制定相应的护理对策。     

非小细胞肺癌患者血浆纤维蛋白原检测的临床意义

目的探讨非小细胞肺癌(NSCLC)患者血浆纤维蛋白原水平与肺癌临床病理特征关系及预后的相关性。方法对55例NSCLC患者及20例健康人的血浆纤维蛋白原分别进行测定。结果NSCLC患者血浆纤维蛋白原水平显著高于健康对照组(P<0.01),肺癌患者血浆纤维蛋白原水平与患者的病理类型、TNM分期之间无明显关系。NSCLC患者血浆纤维蛋白原水平与其生存期之间有显著的负相关(r=-0.37,P<0.01)。结论NSCLC患者存在血浆纤维蛋白原水平增高,血液存在高凝状态;血浆纤维蛋白原水平与患者的生存期呈负相关,血浆纤维蛋白原是反映NSCLC患者预后的重要指标。     

艾滋病合并肺癌、肺结核合并肺癌与单纯肺癌的病理特征及肺内占位CT特征的比较

目的 分析艾滋病合并肺癌、肺结核合并肺癌与单纯肺癌的病理特征及肺内占位CT特征。方法 选择2021年11月～2022年6月我院收治的36例艾滋病合并肺癌、36例肺结核合并肺癌及36例单纯肺癌患者为研究对象,收集其一般资料、临床症状、病理特征、肺内占位CT特征等临床资料,并将3组患者上述资料进行对比分析。结果 艾滋病合并肺癌组、肺结核合并肺癌组发热、纳差比例均高于单纯肺癌组（P<0.05）,艾滋病合并肺癌组贫血、真菌感染比例高于肺结核合并肺癌、单纯肺癌组（P<0.05）,3组其他临床症状差异无统计学意义（P>0.05）。艾滋病合并肺癌组腺癌比例高于肺结核合并肺癌组、单纯肺癌组（P<0.05）,鳞癌比例低于肺结核合并肺癌组、单纯肺癌组（P<0.05）,肺结核合并肺癌组病理分型与单纯肺癌组的差异均无统计学意义（P>0.05）,3组TNM分期差异均无统计学意义（P>0.05）。艾滋病合并肺癌组肺内占位CT表现中纤维条索影比例均高于肺结核合并肺癌组和单纯肺癌组（P<0.05）;肺结核合并肺癌患者肺内占位CT表现中长毛刺征、空洞、纵膈淋巴结增大、胸腔...     

Incidence of bladder cancer discovered by urethrocystoscopy at prostate biopsy: extraordinary high incidence of tiny bladder cancer in elderly males

In order to clarify the incidence of bladder cancer with and without prostate cancer, we investigated bladder cancer discovered incidentally by urethrocystoscopy at prostate biopsy. Between April 1997 and December 2003, 498 patients who were suspected prostate cancer were performed prostate biopsy and urethrocystoscopy simultaneously. We investigate possible invasion of prostate cancer into the urethra or bladder mucosa as well as bladder cancer, including other benign lesions of the bladder by urethrocystoscopy. Prostate cancer was confirmed in 175 (35.1%) of the 498 patients histologically, and bladder cancer was discovered incidentally in 12 patients (2.4 %). The incidence of bladder cancer in patients with prostate cancer of 2.3% (4/175) was not significantly different from that in patients without prostate cancer, which was 2.5% (8/323). Superficial and those with a size less than 1 cm were noted in 11 patients (92%) and 10 patients (83%) respectively. High incidence rate of bladder cancer with prostate cancer was reported previously, however, there was no study to compare the incidence rate of bladder cancer between cases with and without prostate cancer. The present study suggests that asymptomatic tiny bladder cancer may be present at an unexpectedly high incidence rate in elderly males.     

Prelude to specialization: US cancer nursing, 1920-50

This study used historical research methodology to assess the work of US nurses caring for patients with cancer from 1920 to 1950. Primary sources, obtained from several US archives, included nursing procedure books, student nurses' lecture notes, hospital and nursing annual reports, and meeting minutes. Secondary sources included journal articles and textbooks. The aim was to document the clinical work of nurses caring for patients with cancer and assess this work for evidence of emerging specialization in cancer nursing. Following a review of cancer in the 1920s, nursing education specific to cancer, nursing care related to specific cancer therapies, and the practice of concealing a diagnosis of cancer, were examined. Nurses were consistently educated in cancer nursing, but their cancer education became more focused over the decades. Nurses were closely involved with cancer patients as they monitored their patients' radium or assisted patients following radical surgery. The issue of concealing the diagnosis of cancer was problematic to some nurses. This paper reveals the nature of nurses' hospital work with cancer patients and demonstrates a core body of cancer nursing knowledge. The emergence of cancer nursing as a specialty is presented.     

老年人肺癌与血清胆固醇水平关系分析

目的　探讨老年人肺癌与血清胆固醇水平的关系。方法　收集 1996～ 2 0 0 1年间老年肺癌住院患者 79例 ,对血清胆固醇水平等临床资料进行分析 ,并与肺部良性疾病进行比较。结果　老年肺癌组患者血清胆固醇浓度显著低于肺部良性疾病组 (P <0 0 1)。老年肺癌组胆固醇浓度随着病情恶化逐渐降低 (P <0 0 1)。死亡前 1个月内 10 0 %低于肺部良性疾病组平均值。结论　老年肺癌组患者血清胆固醇浓度比肺部良性疾病组显著降低 ,以死亡前 1个月内更为明显 ,这种变化可能对老年肺癌患者的生存时间有预测意义。     

Colorectal cancer surveillance for patients with inflammatory bowel disease

Although the cumulative prevalence of colorectal cancer among patients with ulcerative colitis is similar to that among patients with sporadic colorectal cancer, the younger age of ulcerative colitis patients with cancer accounts for the age-specific relative risk. Approximately half of ulcerative colitis patients with colorectal cancer die from metastatic disease. Pancolitis of long duration and coexistent primary sclerosing cholangitis are strong risk factors for cancer that should prompt entry into cancer surveillance programs. When done appropriately, cancer surveillance in patients with inflammatory bowel disease can be very effective, and at a reasonable cost.     

肺癌患者心理健康状况与应对方式的相关性研究

目的了解肺癌患者的心理健康状况与应对方式的关系。方法对60例肺癌患者用症状自评量表和医学应对方式问卷进行调查。结果肺癌患者心理健康状况与常模比较,差异有显著意义(P0.05),肺癌患者心理健康状况与应对方式之间存在一定相关。结论应重视对肺癌患者的心理干预,采取积极有效的应对方式缓解肺癌患者的心理压力。     

The relation between serum selenium value and cancer in Miyagi,Japan: 5-year follow up study

To determine the relation between serum selenium (Se) values and the development of cancer, we compared serum Se levels among cancer patients, non-cancer patients, and healthy adults. Serum Se values in cancer patients were examined with respect to primary cancer sites separately. We tracked non-cancer patients and healthy people for 5 years after serum collection to examine whether low Se status is a risk factor for cancer. The mean serum Se values in cancer patients were significantly lower than in non-cancer patients. This difference, however, failed to exist in women 50 years of age and less. In the examination of serum Se values with respect to organs with primary cancer, mean serum Se values for 6 organs were significantly lower than those in non-cancer patients and healthy people. However, female breast cancer patients showed a higher value. During the 5 year follow up, patients who developed cancer had lower values than that in subject who remained non-cancer and sex differences were absent. We were unable to rule out low Se status, as a possible risk factor for cancer, a result supported by our 5-year follow-up. In distribution of non-cancer patients classified by serum Se values, the proportion of patients with low serum Se values (80 ppb or less) was relatively high (12%). If low Se status increases the risk of cancer, low Se status as a risk factor for cancer should be considered even in Japan, where Se intake is sufficient.     

疼痛对癌症患者生活质量影响的观察

目的 探讨癌痛对患生活质量的影响及疼痛治疗对癌症患生活质量影响的理论依据。方法 对70例晚期癌症疼痛的患进行癌痛治疗前后生活质量问卷调查，包括躯体、心理和社会人际关系等方面。结果 轻度疼痛对患的生活质量影响较小，而中、重度疼痛对患的生活质量影响明显增大。对镇痛治疗有效生活质量有较大改善。结论 疼痛是癌症患的主要症状之一。疼痛对机体的躯体、精神心理、社会人际关系等方面均可产生不同程度的影响，全面影响患的生活质量，有效的镇痛治疗可明显改善患的生活质量。护士对患进行有关疼痛知识的宣教，在工作中寻求各种方法减轻患的疼痛，是提高癌症患生活质量的重要措施之一。     

Report of 111 patients with multiple cancers of the first medical department of the Vienna-Lainz nursing home 1981-1987]

After a short synopsis of the literature we describe 111 patients with multiple primary cancer and compare these patients with 804 patients with solitary cancer admitted over the same period. Patients who developed primary cancer at a younger age are more prone to developing a second cancer than patients who developed cancer first at an older age. This concerns younger women with breast or genital cancer, who are much more likely to develop a second cancer than older women; nevertheless these women have a more favourable prognosis. As the great majority of patients were already over 70 at the time of diagnosis of the second cancer, the prognosis of geriatric diseases has become of considerable significance. We present a detailed investigation of the interrelations between the first and second cancer, also between oncological and geriatric diseases.     

Distinct features of second primary malignancies in head and neck cancer patients in Japan

Second primary malignancies (SPMs) are one of the most critical problems in treating head and neck cancer patients. Our hospital had 742 patients with a diagnosis of malignant head and neck tumors during the five-year period from 2002 to 2006. In this study, we analyzed 360 of those patients who were assumed to have risk factors such as alcohol and tobacco use: 106 oral, 120 laryngeal, 50 oropharyngeal and 84 hypopharyngeal cancer patients. Synchronous SPMs are defined as second cancers diagnosed at the same time or within 6 months of the diagnosis of the index head and neck cancers. There were 4 (3.8%) and 11 (10.4%) oral cancer patients, 11 (8.3%) and 8 (5.8%) laryngeal cancer patients, 7 (14.0%) and 4 (8.0%) oropharyngeal cancer patients, and 30 (28.6%) and 7 (8.3%) hypopharyngeal cancer patients with synchronous and metachronous SPMs, respectively. The number of metachronous patients with synchronous SPMs tended to increase during this time period. The frequencies of SPMs in oropharyngeal and hypopharyngeal cancer patients are similar to those in oral and laryngeal cancer patients. Notably, the most frequent SPMs are upper gastrointestinal tract cancers in Japan, compared to lung cancers in Europe. The five-year overall survival rate of patients with synchronous SPMs was significantly poorer than that of patients without any other tumor except for the index cancer, according to the Kaplan-Meier analysis. In conclusion, searching for SPMs in the upper gastrointestinal tract is a critical issue in head and neck cancer patients in Japan.     

癌症患者住院化疗期间健康信息需求状况调查分析

目的:探讨癌症患者住院化疗期间健康信息需求情况并分析其相关因素,为癌症患者的临床护理提供参考。方法:应用一般资料问卷、癌症患者健康信息需求量表对北京市某三级甲等医院肿瘤科的69例癌症住院化疗患者进行调查。结果:癌症患者住院化疗期间的整体健康信息需求为低度到中度(1.39±0.47)分,患者对于疾病治疗、症状控制信息的需求较高;患者的健康信息需求与其疲乏程度具有相关性,重度疲乏患者的健康信息需求高于轻度疲乏患者(P<0.05)。结论:癌症患者住院化疗期间具有轻到中度的健康信息需求,患者的健康信息需求程度与其疲乏程度呈正相关,临床工作中应有针对性地对患者进行个体化化的健康信息支持。     

子宫内膜异位症合并卵巢恶性肿瘤的临床特点

  目的  探讨子宫内膜异位症合并卵巢恶性肿瘤的临床特点。  方法  对北京协和医院1997年1月至2009年4月间收治的子宫内膜异位症合并卵巢恶性肿瘤的患者共33例进行回顾性分析, 并总结其临床特点。  结果  33例子宫内膜异位症合并卵巢恶性肿瘤患者的平均年龄为45.3岁; 病理类型以透明细胞癌为主; 诊断时分期多为Ⅰ期(24/33);5例患者同时又合并子宫内膜病变; 子宫内膜异位症病灶位于卵巢者19例, 位于卵巢外者14例; 术后5年生存率为60%, 平均无瘤生存期为41.9个月。  结论  子宫内膜异位症合并卵巢恶性肿瘤患者发病年龄较卵巢癌患者年轻, 病理类型以卵巢上皮性肿瘤为主, 透明细胞癌最为常见, 可同时合并有在位子宫内膜肿瘤。合并子宫内膜异位症可能是卵巢癌预后好的指标。     

中国幽门螺杆菌感染与胃癌关系的Meta分析

目的综合分析幽门螺杆菌(HP)感染与胃癌的关系方法计算机检索中国期刊全文数据库、万方数据库,检索时间从1995年1月至2005年12月。纳入HP感染与胃癌关系的病例对照研究。用Meta分析方法对数据进行处理,估计其综合OR值和95％CI。结果共纳入14个研究,其中以正常人为对照的研究11个,以胃炎病人为对照的研究3个。按对照来源进行亚组分析,结果表明正常人与病例相比差异有统计学意义[OR合并2．00,95％CI(1．25,3．20)],而胃炎病人与病例相比差异无统计学意义[OR合并1．54,95％CI(0．68,3．50)]。按胃癌的部位进行亚组分析,结果显示胃非贲门癌与对照的差异有统计学意义[OR合并3．60,95％CI(1．25,10．36)],而胃贲门癌与对照的差异无统计学意义[OR合并0．88,95%CI(0．56,1．39)]。结论HP感染与胃癌相关,导致各研究结果不一致的原因主要是胃癌的部位和对照的选择。     

Gabapentin for Cough in Cancer

Cough is a common problem among cancer patients, especially lung cancer patients. Gabapentin has been shown to be effective in reducing cough number and severity in patients with idiopathic refractory cough. The authors report here the successful use of gabapentin at usual doses to treat cough in cancer patients, including two with lung cancer, with minimal side effects. Gabapentin may be a useful addition to the symptom management toolbox for palliation of cancer symptoms.     

Treatment Considerations for Cancer Pain: A Global Perspective

Cancer pain is prevalent, undertreated, and feared by patients with cancer. In April 2013, a panel of pain experts convened in Singapore to address the treatment of cancer pain. They discussed the various types of cancer pain, including breakthrough pain, which is sometimes clinically confused with analgesic gaps. Reasons for undertreating cancer pain include attitudes of patients, clinicians, and factors associated with healthcare systems. The consequences of not treating cancer pain may include reduced quality of life for patients with cancer (who now live longer than ever), functional decline, and increased psychological stress. Early analgesic intervention for cancer pain may reduce the risk of central sensitization and chronification of pain. To manage pain in oncology patients, clinicians should assess pain during regular follow‐up visits using validated pain measurement tools and follow prescribing guidelines, if necessary referring patients with cancer to pain specialists. Many patients with cancer require opioids for pain relief. Pain associated with cancer may also relate to cancer treatments, such as chemotherapy‐induced peripheral neuropathy. Many patients with cancer are what might be considered “special populations,” in that they may be elderly, frail, comorbid, or have end‐stage organ failure. Specific pain therapy guidelines for those populations are reviewed. Patients with cancer with a history of or active substance abuse disorder deserve pain control but may require close medical supervision. While much “treatment inertia” exists in cancer pain control, cancer pain can be safely and effectively managed and should be carried out to alleviate suffering and improve outcomes.