李斌华

[摘要] 目的 探讨舒缓治疗对肝癌终末期患者治疗的作用。 方法 选取于2017年2月～2018年1月于我科住院的肝癌终末期患者40 例，分为对照组和实验组各20 例。对照组给予临床常规诊疗方案，实验组则给予舒缓治疗方案。 结果 干预后，实验组的HAMA评分、癌痛评分明显低于对照组，生活质量明显高于对照组，差异均具有统计学意义（P<0.05）。 结论 舒缓治疗可有效提高肝癌终末期患者的生存质量，值得临床推广和应用。

[关键词] 舒缓治疗；肝癌；癌痛；生存质量

[中图分类号] R735.7 [文献标识码] B [文章编号] 1673-9701（2018）15-0088-03

Influence of palliative care on the quality of life in patients with end-stage liver cancer

LI Binhua

Hepatic Department，the Second Peoples Hospital of Lanzhou City，Lanzhou 730046，China

[Abstract] Objective To investigate the effectiveness of palliative care in the treatment of patients with end-stage liver cancer. Methods 40 patients with end-stage liver cancer in our hospital from February 2017 to January 2018 were selected and divided into control group and study group， with 20 patients in each group. Patients in control group were treated with the conventional clinical regimen while patients in study group were treated with the regimen of palliative care. Results After the intervention， scores of HAMA and caner pain in study group were significantly lower than those in control group while the quality of life in study group was significantly better than that in control group（P<0.05）. Conclusion Palliative care could improve the life quality of patients with end-stage liver cancer effectively. It was worth clinical promotion and application.

[Key words] Palliative Care；Liver Cancer；Cancer Pain；Quality of Life

肝癌是我国常见的恶性肿瘤之一，发病率逐年上升，因其具有高度恶性和高病死率的特点，被誉为“癌中之王”。肝癌一般起病隐匿、病情进展快、侵袭性强，多数患者一发病就处于肝癌终末期状态，治疗手段单一、预后差，一般确诊后生存期不超过6个月。这些患者要承受诸如疼痛、恐惧、绝望等生理、心理上的折磨。据相关调查显示，50%～80%左右的肝癌患者在疾病终末期均会受到不同程度的癌痛折磨，严重影响其生存质量[1]，对患者及家属的心理和治疗的依存性造成一定的影响，进而降低了癌症治疗的效果。隨着“以人为本”治疗理念的深入人心，越来越多的肝癌患者希望“有质量的活，有尊严的死”。因此通过心理护理、健康教育、控制癌痛等手段，达到缓解疼痛、改善生存质量的舒缓治疗成为肝癌治疗的重要辅助手段。

1 资料与方法

1.1 一般资料

抽取2017年2月～2018年1月于我科住院治疗的肝癌终末期合并中重度疼痛等症状、仅接受内科姑息治疗的患者40例。其中男28例，女12例，年龄37～65 岁，平均（55.3±1.1） 岁。……