摘要
目的评价近10年来上海市推行《中国常见恶性肿瘤诊治规范》(胃癌)的效果,为卫生行政部门进一步促进该项工作提供科学决策依据。方法采用连续跟踪、随机抽样的方法,检查二、三级医院的胃癌出院病例,以《规范》为标准,并请胃癌专家评审。结果上海市胃癌总体规范治疗率为29.93%,基本规范治疗率为45.77%,两率合计为75.70%,比1994年提高了25.7个百分点;不规范治疗率比1994年下降了4.5个百分点;市级、区级医院规范治疗率高于县级医院;市级医院基本规范治疗率高,比较稳定。手术治疗病例的规范治疗率较高(33.49%);在明确分期的病例中占34.51%。结论上海市通过推行《诊治规范》,使胃癌规范治疗率有所上升。应采取针对性措施,加大培训和质控力度,创造支持性环境,探索有机的综合治疗工作模式,制定转诊政策,进一步提高恶性肿瘤的诊治水平,以提高治愈率、生存率和生活质量。
Objective To evaluate the implementation of 'Guidelines for Diagnosis and Treatment of Common Cancers in China'(Chapter of Stomach Cancer) during the period 1994-1999, and to provide investigative data for the Public Health Administration to push forward the application of the Guidelines. Methods Samples of case histories of discharged stomach cancer patients were picked out at random, followed-up continuously, and evaluated by clinical experts according to the guidelines. Results From 1994 to 1999, the number of cases managed according to the Guidelines was 29.93%, partially concordant in 45.77%, when the 2 rates were added up,the figure was 75.70%, which increased 25.7% when compared to the figure of 1994. The concordance rate in municipal and district hospitals were higher than in county hospitals. The partial concordance rate in municipal hospitals ranked highest, and remained stable. The concordance rate of cases receiving surgery was high (33.49%), and the figure in cases with correct staging was 34.51%.Conclusions Through the enforcement of 'Guidelines for Diagnosis and Treatment of Common Cancers in China',the concordance rate for stomach cancer is increasing. In order to improve further the cure rate, survival rate and the quality of life in stomach cancer cases, measures should be taken to enforce training and quality control, to create supportive environment, to explore appropriate combined therapy and to establish policies to facilitate patient transfer.
出处
《外科理论与实践》
2004年第2期130-132,共3页
Journal of Surgery Concepts & Practice
关键词
恶性肿瘤
胃癌
诊治规范
效果评估
Gastric cancer
Guideline of diagnosis and treatment
Evaluation
