本文選題：WONCA　切入點(diǎn)：前列腺癌患者　出處：《中國(guó)全科醫(yī)學(xué)》2016年22期 　論文類型：期刊論文

【摘要】：目的目前積極治療(手術(shù)或放射治療)在局限性前列腺癌(LPC)患者中的臨床獲益尚不明確,故LPC的過(guò)度醫(yī)療篩查仍然是一項(xiàng)重要的公共衛(wèi)生問(wèn)題,本研究旨在探討是否采取積極治療對(duì)LPC患者預(yù)期壽命的影響。方法選取年齡≤75歲的近期確診LPC患者260例,其中黑色人種132例,白色人種128例。采用自填式問(wèn)卷調(diào)查不同治療方案患者的預(yù)期壽命,并采用多因素分析探討患者預(yù)期壽命的影響因素。結(jié)果在未采取積極治療的患者中,33%預(yù)期壽命5年,41%預(yù)期壽命5~10年,21%預(yù)期壽命11~20年,5%預(yù)期壽命20年;在采取積極治療的患者中,3%預(yù)期壽命5年,9%預(yù)期壽命5~10年,33%預(yù)期壽命11~20年,55%預(yù)期壽命20年。不同治療方案選擇情況、健康觀念、已知癌癥嚴(yán)重程度患者的預(yù)期壽命間有差異,而不同種族、實(shí)際腫瘤風(fēng)險(xiǎn)患者的預(yù)期壽命間無(wú)差異。對(duì)其他因素進(jìn)行調(diào)整后,選擇手術(shù)或放射治療患者的預(yù)期壽命長(zhǎng)于未選擇積極治療或選擇積極監(jiān)測(cè)治療的患者。結(jié)論大部分LPC患者低估了自身不采取積極治療后的預(yù)期壽命,而高估了選擇手術(shù)或放射治療等積極治療后的預(yù)期壽命。不合理的預(yù)期可能會(huì)影響到患者選擇正確治療方案的能力,導(dǎo)致LPC過(guò)度醫(yī)療的發(fā)生,臨床醫(yī)生應(yīng)幫助參與個(gè)人治療決策的患者做出合理預(yù)期和治療選擇。
[Abstract]:The purpose of the active treatment (surgery or radiotherapy) in localized prostate cancer (LPC) clinical benefit in patients with excessive medical screening is not clear, so LPC is still an important public health problem, this study aims to investigate whether to take active treatment effect on patients with LPC. Methods the life expectancy of older than the 75 year old recently diagnosed LPC patients 260 cases, including 132 cases of black and white in 128 cases. Using a self-administered questionnaire of life expectancy of different treatment of patients, and to analyze the impact on life expectancy factors. By using multi factor results in not taking positive patients, 33% life expectancy of 5 years. 41% 5~10 21% years of life expectancy, life expectancy of 11~20 5% years, life expectancy of 20 years; in the actively treated patients, 3% life expectancy of 5 years, 9% years life expectancy of 5~10 33%, 11~20 55% years of life expectancy, the life expectancy of 20 years. The same treatment options, concepts of health, life expectancy of known cancer severity in patients with the difference between the different races, but, no difference in life expectancy with the actual risk of cancer. After adjustment for other factors, choice of surgery or radiation therapy in patients with life expectancy than the non active treatment or choose active surveillance treatment conclusion the majority of patients. LPC patients underestimate their own do not take life expectancy after active treatment, and overestimated the life expectancy of surgical operation or radiotherapy after active treatment. Unreasonable expectations may affect the patients ability to choose the right treatment plan, LPC lead to excessive medical treatment, clinicians should help individuals involved in treatment decisions the patients choose to make reasonable expectations and treatment.

【分類號(hào)】：R737.25

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