Cancer Pain Whole Process Management The Mode of Integration Among Doctors,Nurses And Pharmacists Day Treatment Ward
目的：随机对照研究比较医护药一体化与医护一体化两种管理模式对癌痛患者控制效果的影响。方法：按照入组标准选取患者120例，随机分为两组，医护一体化管理组（对照组）和医护药一体化管理组（观察组），每组60例。对照组按照医护一体化管理模式进行疼痛全程管理并观察癌痛控制效果。观察组在医护一体化管理模式的基础上引入临床药师介入，开展癌痛评估干预。通过观察干预后第1、3、7天的疼痛评分、生活质量评分，评价两组的癌痛控制效果。结果：观察组疼痛视觉模拟评分（VAS）很快改善，干预后第3天患者的VAS评分为2.78±0.26；对照组虽下降，但大于3分。第7天对照组VAS评分降低至2.88±0.22，生活质量卡氏功能状态量表（KPS）评分提高至78.5±2.14；观察组VAS评分降低至1.56±0.24，KPS评分提高至88.7±2.21，且第3天和第7天观察组与对照组相比改善明显（P < 0.01）。结论：医护药一体化全程管理模式提升了日间治疗病房肿瘤患者癌痛控制的效果，改善了患者的生活质量。
Objective：A randomized controlled study was conducted to compare the effects of to management modes of the integration among doctor，nurses and pharmacistsand and mode of integration of doctors and nurseson on cancer pain patients. Methods：A total of 120 patients were selected according to the enrollment criteria and randomly divided into two groups，the integrated management of doctors and nurses group（control group）and the integrated management among doctor，nurses and pharmacists（observation group），with 60 patients in each group. In the control group，the pain was managed according to the integrated management mode of doctors and nurses，and the control effect of cancer pain was observed. The intervention of clinical pharmacists was introduced to evaluate cancer pain on the basis of the integrated management mode of doctors and nurses in the observation group. Pain score and quality of life score on day 1，3 and 7 after intervention were observed to evaluate the effect of cancer pain control in the two groups. Results：The scores of pain and quality of life were improved in control group and observation group before and after intervention. The visual analogue scale（VAS）of the observation group quickly improved，and the VAS score of the patients on the third day after intervention was 2.78±0.26，while that of the control group decreased，but was more than 3 points. On the 7th day，the VAS score of the control group decreased to 2.88±0.22，the Karnofsky functional state scale（KPS）score of the quality of life was increased to 78.5±2.14（P < 0.01），and the VAS score of the observation group decreased to 1.56±0.24. KPS score increased to 88.7±2.21，and the observation group significantly improved compared with the control group on day 3 and day 7（P < 0.01）. Conclusion：The cancer pain control effect and the quality of life of patients in the day ward was improved by the mode of integration among doctor，nurses and pharmacists for the whole process management of cancer pain.