医療用麻薬導入前後での療養病棟におけるがん緩和ケアの実態調査  [in Japanese] A Retrospective Study between Pre- and Post-Introduction of Narcotic Drugs of Palliative Care for Cancer Patients at the Long-term Care Unit  [in Japanese]

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Abstract

【目的】療養病棟でがん患者の緩和ケアを行った成績を検討した.【方法】2010年4月~2014年12月に当院医療療養病棟へ入院した194名について,医療用麻薬(麻薬)不使用期(2012年3月まで:前期)と麻薬使用期(2012年4月以降:後期)の2群に分け,患者背景,入院期間,転帰,麻薬投与,苦痛緩和等について後方視調査した.比較のため緩和ケア病棟(PCU)の入院動態を調査した.【結果】前期74名中がん患者は16名(22%),後期120名中がん患者は79名(66%)と後期でがん患者の割合が3倍に増えた(p<0.01).後期の入院期間は1/2(144日)に短縮(p<0.01),死亡退院率(78%)は増えた(p<0.05).後期はがん患者の半数以上(57%)に麻薬を投与し,疼痛緩和は良好であった.後期の期間はPCU入院患者も増加した.【結語】療養病棟はPCUと連携してがん緩和ケアを行える可能性が示唆された.

Objective: The aim of this study was to investigate the palliative care for cancer patients provided by a long-term care unit. Methods: We retrospectively investigated the medical records of 194 patients who hospitalized in our long-term care unit between April 2010 and December 2014. The patients shared with a group of two, narcotic drugs non-use period (previous group; until March 2012) and narcotics use period (later group; in April 2012 or later), and it was compared with a background, hospitalization period, result on discharge, narcotic drug administration, symptom relief. And it was surveyed hospitalization dynamics of our palliative care unit for comparison. Result: Cancer patients were 16 (22%) in previous group of 74 patients and were 79 (66%) in later group of 120. The proportion of cancer patients in later group increased to three times (p<0.001). In later group, the average hospital stay was shortened to half (144 days, p<0.01) and the mortality discharge rates increased (78%, p<0.05). Narcotic drugs were administered to more than half (57%) of cancer patients in later group, and pain relief was significantly better. In the period of later group, number of hospitalized patients in palliative care unit was also increased. Conclusion: It was suggested that the long-term unit can perform palliative care for cancer patients in cooperation with the palliative care unit.

Journal

  • Palliative Care Research

    Palliative Care Research 11(1), 109-115, 2016

    Japanese Society for Palliative Medicine

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