于恺英, 于世英, 巴一, 谌永毅, 李薇, 石汉平. 中国肿瘤支持治疗关键临床技术的发展与进步[J]. 中国肿瘤临床, 2020, 47(5): 222-226. DOI: 10.3969/j.issn.1000-8179.2020.05.103
引用本文: 于恺英, 于世英, 巴一, 谌永毅, 李薇, 石汉平. 中国肿瘤支持治疗关键临床技术的发展与进步[J]. 中国肿瘤临床, 2020, 47(5): 222-226. DOI: 10.3969/j.issn.1000-8179.2020.05.103
Kaiying Yu, Shiying Yu, Yi Ba, Yongyi Chen, Wei Li, Hanping Shi. Development and progress in key clinical technologies of cancer supportive care in China[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2020, 47(5): 222-226. DOI: 10.3969/j.issn.1000-8179.2020.05.103
Citation: Kaiying Yu, Shiying Yu, Yi Ba, Yongyi Chen, Wei Li, Hanping Shi. Development and progress in key clinical technologies of cancer supportive care in China[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2020, 47(5): 222-226. DOI: 10.3969/j.issn.1000-8179.2020.05.103

中国肿瘤支持治疗关键临床技术的发展与进步

Development and progress in key clinical technologies of cancer supportive care in China

  • 摘要: 近些年,中国肿瘤支持治疗关键临床技术发展已取得多项临床成果:1)支持治疗观念显著改变:充分认识到支持治疗是肿瘤综合治疗的核心措施,并在临床广泛应用。2)明确了支持治疗团队组成及其运作模式:确定了理想支持治疗团队组成,明确了支持治疗“三位一体”运作模式。3)工作范畴日渐明晰:提出了支持治疗七个方面工作范畴,倡导“身心社灵”全人支持治疗模式。开展“无痛、无血、无栓、无饿、无忧”示范病房建设。4)癌痛治疗逐步规范:组建癌痛多学科团队,建立门诊癌痛随访系统,重视癌痛科普教育和政策宣教。5)肿瘤患者营养诊疗体系基本建立:提倡入院患者进行肿瘤和营养不良的双诊断,率先提出肿瘤患者营养不良的三级诊断和五阶梯治疗。6)支持治疗延续和拓展:提出了医院-社区-家庭分级营养管理,构建立体整合营养治疗体系。7)生存质量得到重视:建立新型肿瘤患者生存质量评估方法,构建了终末期肿瘤患者生存预测模型。8)肿瘤患者的护理更加全面:将“灵性”的概念引入肿瘤患者的照护。借助互联网技术和“虚拟现实”技术,研发了延续护理服务管理平台。本文就上述成果进行总结。

     

    Abstract: This study summarizes the clinical achievement in key technologies of cancer supportive care. 1) Conceptual change. Medical teams now recognize supportive care as the core of comprehensive treatments for cancer. Supportive care is widely implemented clinically. 2) Team composition and operation mode. The program shapes an ideal supportive care team. The ideal team shall operate as one of the three models:solo practice model, congress practice model, or integrated care model according to the actual situation. 3) Scope of work. Supportive care team provides patients with spiritual care, pharmacologic assist, exercise guidance, nutritional support, effective communication, emotional support, and rehabilitation consultation. Efforts have been made to set up demonstrative wards that are free of pain, bleeding, thrombosis, hunger, and depression nationwide. 4) Standardized pain management for cancer patients. To optimize pain management, a multidisciplinary team is formed, an outpatient follow-up system is set up, and the focus is put on cancer pain education and policy advocacy. 5) A system of nutritional diagnosis and treatment. It urges the bi-diagnosis of cancer and malnutrition for inpatients and leads the proposal of the three-level diagnosis and five-ladder therapy for malnutrition. 6) Extension and expansion of supportive care out of the hospital. The program proposes the hospital-community-home management model, an integrated model for comprehensive nutritional therapy. 7) Emphasis on the quality of life. A new quality of life assessment method for cancer patients and a survival prediction model for end-stage cancer patients are established. 8) Comprehensive nursing care. It integrates spiritual care into the care of cancer patients. A management platform for continuous care service is developed with the help of internet technology and virtual reality.

     

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