BMJ：癌症诊断前后警惕医源性及非医源性损伤

2016-09-01 MedSci MedSci原创

本研究旨在探究癌症诊断前后患者医源性和非医源性损伤的相对危险性。研究数据来源于瑞典国家人口和健康登记册，1991-2009年间共有720901名癌症诊断者。确定所有与医源性或非医源性相关的损伤。在同一患者中使用条件泊松回归分析对比 “诊断期”（诊断前后16周）损伤发病率与“诊断前期”（诊断前一年相同的32周）的损伤发病率。诊断期间，共有7306例医源性（发病率,每0.60/

本研究旨在探究癌症诊断前后患者医源性和非医源性损伤的相对危险性。

研究数据来源于瑞典国家人口和健康登记册，1991-2009年间共有720901名癌症诊断者。

确定所有与医源性或非医源性相关的损伤。在同一患者中使用条件泊松回归分析对比 “诊断期”（诊断前后16周）损伤发病率与“诊断前期”（诊断前一年相同的32周）的损伤发病率。

诊断期间，共有7306例医源性（发病率,每0.60/1000人月）和8331例非医源性损伤（发病率,0.69/1000人月）。与诊断前期相比，诊断期医源性损伤的发生率比为7（95%可信区间为6.6-7.4）。癌症诊断前两周损伤的风险增加，并在诊断后的两周达到高峰（48.6，37.3-63.5）。

与诊断前期相比，诊断期非医源性损伤的发生率比为1.9（1.9-2）。癌症诊断前四周损伤的风险增加，并在诊断前两周达到高峰（5.3，4.6-6.1）。对于所有常见的癌症，诊断期间这两种类型的损伤的风险均增加，但是，非黑色素瘤皮肤癌中损伤的风险增加最小。

总而言之，该研究发现，癌症患者医源性和非医源性损伤的风险高度增加，需要在诊断前后短期内接受住院护理。这些研究结果进一步揭示了医疗并发症的总负担，并呼吁在癌症诊断过程中预防有意或无意的损伤。

原始出处：

Qing Shen, Donghao Lu, et al., Injuries before and after diagnosis of cancer: nationwide register based study. BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i4218.

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2017-01-25 gaoxiaoe

#BMJ#

64 0
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2016-09-11 李东泽

很好，不错，以后会多学习

107 0
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2016-09-03 ms9833124466084992

#癌症诊断#

61 0
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2016-09-03 ms3046638856685384

#损伤#

50 0
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objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Fri Sep 02 10:47:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109455, encodeId=bd241094554e, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151110/IMG5641A6F12C0732294.jpg, createdBy=2f901662448, createdName=乐奕11, createdTime=Fri Sep 02 10:14:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109431, 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2016-09-03 方舒

有道理

116 0
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objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Fri Sep 02 10:47:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109455, encodeId=bd241094554e, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151110/IMG5641A6F12C0732294.jpg, createdBy=2f901662448, createdName=乐奕11, createdTime=Fri Sep 02 10:14:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109431, encodeId=a969109431cf, content=新视角，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Fri Sep 02 09:55:00 CST 2016, time=2016-09-02, status=1, ipAttribution=)]
2016-09-02 明崖

学习了，可以多研究

120 0
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objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Fri Sep 02 10:47:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109455, encodeId=bd241094554e, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151110/IMG5641A6F12C0732294.jpg, createdBy=2f901662448, createdName=乐奕11, createdTime=Fri Sep 02 10:14:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109431, encodeId=a969109431cf, content=新视角，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Fri Sep 02 09:55:00 CST 2016, time=2016-09-02, status=1, ipAttribution=)]
2016-09-02 doctorJiangchao

继续关注

107 0
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encodeId=a969109431cf, content=新视角，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Fri Sep 02 09:55:00 CST 2016, time=2016-09-02, status=1, ipAttribution=)]
2016-09-02 doctorJiangchao

继续学习

90 0
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content=学习了，可以多研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Fri Sep 02 12:07:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109487, encodeId=2a9310948ecb, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Fri Sep 02 10:47:00 CST 2016, time=2016-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=109486, encodeId=c87010948640, content=继续学习, beContent=null, 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2016-09-02 乐奕11

厉害

43 0
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2016-09-02 xiaotaiyang1

新视角，学习了

52 0