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目的查找循证医学证据,为16例结直肠癌骨转移患者制定合理的治疗方案。方法针对患者的临床问题,以metastatic colorectal cancer,RCT,human,systematic review,meta-analysis等为检索词,电子检索Cochrane图书馆(2010年第1期)、EMBASE(2005,1-2010,12)和Black Well electronic journals(2005,1-2010,12)查找相关的系统评价、随机对照试验等,并对所获得证据进行质量评价。结果从Cochrane临床试验中心登记库查到临床对照15篇,从EMBASE及Black Well electronic journals检索到Meta分析10篇,随机对照试验8篇,结果显示对转移性结直肠患者进行化疗可延缓病情的发展,提高患者的生存率,据此,结合医生经验及患者意愿,对该16例患者进行化疗及其他支持治疗,患者临床症状好转,生活质量提高。结论我们运用循证医学证据为16例结直肠癌骨转移患者选择了合理的治疗方案,但化疗的毒性、对患者生活质量的影响及病情症状的控制程度还需要进一步的高质量、大样本的随机对照试验研究。
Objective To search evidence of evidence-based medicine and develop a reasonable treatment plan for 16 patients with bone metastases of colorectal cancer. Methods According to the clinical problems of patients, the Cochrane Library (2010 Issue 1), EMBASE (2005,1-2010,12) were searched electronically with the terms of metastatic colorectal cancer, RCT, human systematic review and meta- And Black Well electronic journals (2005,1-2010,12) to find out the relevant systematic reviews, randomized controlled trials, etc., and evaluate the quality of the evidence obtained. Results There were 15 clinical controls from the Cochrane Central Register of Repositories, 10 Meta analysis from EMBASE and Black Well electronic journals, and 8 randomized controlled trials. The results showed that chemotherapy could delay the development of metastatic colorectal cancer patients , To improve the survival rate of patients, accordingly, combined with the experience of doctors and the wishes of patients, the 16 patients with chemotherapy and other supportive care, clinical symptoms improved, quality of life improved. Conclusions We used evidence-based medical evidence to select a reasonable regimen for 16 patients with bone metastases of colorectal cancer. However, the toxicity of chemotherapy, the quality of life of patients and the degree of control of the disease symptoms need further high-quality, large sample Randomized controlled trial.