目的分享老年病科临终关怀和姑息治疗的门诊实践,北京协和医院.方法对N医生在老年门诊就诊的连续临床资料进行回顾性分析,北京协和医院2016年1月1日至2019年12月31日。85岁及以上的患者,以及那些患有晚期恶性肿瘤的人,无有效治疗的慢性疾病或原发疾病导致的非肿瘤功能障碍被定义为需要姑息治疗的患者.基本信息,症状,收集了这些患者的咨询目的和治疗方法。结果在研究期间的2502次访视中,1388名需要姑息治疗的患者被收治并记录下来,平均年龄(69.7±13.5)岁(8-105岁),其中73.3%为60岁以上的患者,712名(51.3%)为男性。在这些患者中,63.4%的访视是专门寻求姑息治疗服务,而87.2%的访视是由于晚期恶性肿瘤引起的困扰。在221例非肿瘤疾病患者中,虚弱和神经退行性疾病是威胁生命的主要原因。在记录的5483种症状中,疼痛(21.2%),厌食症(13.1%),疲劳(11.6%),便秘(6.9%),失眠(4.6%),和腹胀(4.6%)是六种常见症状。在2502次访问中,26.2%的患者多次就诊,50.3%的多次就诊患者有3次以上就诊;38.6%的患者自行就诊,65.7%的访视由两个或两个以上家庭成员(包括患者)参加。平均就诊时间为(19.6±8.5)min(2-85min),和13.5%,53.0%,25.6%和7.9%的患者在10,11-20,21-30和30分钟内完成咨询,分别。结论北京协和医院老年病科门诊姑息治疗需求旺盛,为老年病门诊患者提供姑息治疗服务是可行的。
Objective To share the outpatient clinic practice of hospice and palliative care at the Department of Geriatrics,Peking Union Medical College Hospital.Methods We conducted a retrospective analysis on the consecutive clinic data of doctor N in Geriatric Outpatient Clinic,Peking Union Medical College Hospital from January 1,2016 to December 31,2019.The patients aged 85 years and older,as well as those with end stage malignant tumor,non-tumor dysfunction due to chronic diseases or primary diseases without effective treatment were defined as patients with palliative care need.The basic information,symptoms,consultation purposes and treatments of these patients were collected.Results Among the 2502 visits during the study period,1388 patients with palliative care needs were admitted and recorded,with an average age of(69.7±13.5)years(8-105 years),among which 73.3% were patients over 60 years old and 712(51.3%)were males.Among these patients,63.4% visited specifically to seek for palliative care service and 87.2% of the visits were due to distress caused by advanced malignant tumors.Of the 221 patients with non-tumor diseases,frailty and neurodegenerative diseases were the leading life-threating cause.Of the 5483 symptoms recorded,pain(21.2%),anorexia(13.1%),fatigue(11.6%),constipation(6.9%),insomnia(4.6%),and abdominal distension(4.6%)were the six common symptoms.In the 2502 visits,26.2% of the patients had mutiple visits,and 50.3% of the patients with multiple visits had more than three visits;38.6% of patients visited the clinic themselves,and 65.7% of visits were attended by two or more family members(including the patients).The average duration of visit was(19.6±8.5)min(2-85 min),and 13.5%,53.0%,25.6% and 7.9% of the patients completed the consultation within 10,11-20,21-30 and over 30 min,respectively.Conclusion There is strong demand of palliative care in the outpatient clinic of Department of Geriatrics in Peking Union Medical College Hospital and it is feasible to provide palliative care service for patients with serious diseases in geriatric outpatient clinics.