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目的:研究基层医院晚期恶性肿瘤相关贫血临床特点及诊疗现状。方法:回顾性分析2013年1月至2015年6月住院的晚期恶性肿瘤患者395例,分为贫血组及非贫血组,收集各组临床、实验室指标及治疗资料。分析晚期肿瘤相关贫血的影响因素、贫血特点及诊疗现状。结果:晚期恶性肿瘤患者贫血发生率87.8%,logistic回归分析贫血相关因素包括肿瘤部位、化疗及低白蛋白血症(P<0.05)。其中贫血组小细胞贫血32.9%,正细胞贫血62.2%,大细胞贫血4.9%,重度贫血17.3%,中度贫血占55.6%,轻度贫血占27.1%。完善贫血三项筛查者37例占10.7%。治疗方面中医药317例占91.4%。铁剂应用79例占22.8%,促红细胞生成素应用35例占10.1%。结论:基层综合医院晚期恶性肿瘤相关贫血发生率高。贫血以轻、中度的小细胞及正细胞贫血为主。临床实践中需重视恶性肿瘤相关贫血的诊断、评估及规范化治疗。
Objective: To study the clinical features and diagnosis and treatment of advanced malignant tumor in primary hospital. Methods: A retrospective analysis of 395 patients with advanced malignant tumors hospitalized from January 2013 to June 2015 were divided into anemia group and non-anemia group, and clinical and laboratory indexes and treatment data of each group were collected. Analysis of the influencing factors of advanced cancer-related anemia, anemia characteristics and diagnosis and treatment status. Results: The incidence of anemia in patients with advanced malignancy was 87.8%. Logistic regression analysis showed that anemia related factors included tumor site, chemotherapy and hypoalbuminemia (P <0.05). Including anemia group of small cell anemia 32.9%, positive cell anemia 62.2%, large cell anemia 4.9%, severe anemia 17.3%, moderate anemia 55.6%, mild anemia 27.1%. Thirty-seven cases of perfect anemia accounted for 10.7%. 317 cases of Chinese medicine treatment accounted for 91.4%. Iron application of 79 cases accounted for 22.8%, 35 cases of erythropoietin application accounted for 10.1%. Conclusion: The incidence of advanced malignant tumor-related anemia in primary general hospitals is high. Anemia in mild to moderate small cells and positive cell anemia. Clinical practice should pay attention to the diagnosis, evaluation and standardization of malignant tumor-related anemia.