1例晚期原发性肝癌患者的循证治疗

目的借助循证医学的方法为一例晚期原发性肝癌患者确定治疗目标及治疗方案。方法在充分评估患者情况后提出临床问题,从Cochrane图书馆(2010年4期)、PubMed(1980～2010)、EMbase(1990～2010)和万方数据库(1990～2010)上检索,收集与原发性肝癌诊断、治疗有关的证据,并对所获证据进行评价,而后结合医生的经验及患者的愿望制定治疗方案。结果共检出相关文献153篇,最终纳入系统评价/Meta分析13篇,随机对照试验23篇及临床指南4篇。通过对检索结果进行分析结合患者意愿,为患者制定出STACE+3D–CRT+对症支持治疗的综合治疗方案。通过6个月的随访,证实该方案对患者有满意的疗效,远期疗效仍在进一步观察中。结论采用循证治疗的方法,为晚期原发性肝癌患者制定个性化的合理治疗方案,可以有效提高治疗效果,提高患者生存质量。

Evidence-Based Treatment for a Patient with Advanced Hepatocellular Carcinoma

Objective To formulate an evidence-based treatment plan for a patient with advanced hepatocellular carcinoma.Methods The clinical problems were put forward after full evaluation of patient's conditions,and then the evidence related to the diagnosis and treatment of primary hepatocellular carcinoma was collected from The Cochrane Library(Issue 4,2010),PubMed(1980 to 2010),Embase(1990 to 2010) and Wanfang Data(1990 to 2010).All the collected evidence was critically assessed.Both patient preferences and physic...