推拿治疗肿瘤住院患者静脉血栓栓塞的疗效和安全性

A. Ng, G. Francis, Sumler Ss, Diane D. Liu, E. Bruera
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引用次数: 1

摘要

背景:癌症患者在治疗期间发生静脉血栓栓塞(VTE)的频率增加了4 - 7倍,而VTE是一种常见的死亡原因。肿瘤按摩传统上是血栓栓塞患者的禁忌,但研究表明肿瘤按摩可以改善症状和生活质量。目的:本研究的目的是回顾最近有静脉血栓栓塞病史的肿瘤患者按摩的安全性和患者报告的结果。方法:经UT MD Anderson机构审查委员会批准,对25例诊断为静脉血栓栓塞(VTE)后接受肿瘤按摩以缓解症状和提高生活质量的患者进行回顾性分析。对按摩前后的埃德蒙顿症状评估量表(ESAS)评分以及30天内需要返回急诊室或再次住院的并发症进行评估。结果:19名完成ESAS评分的患者报告了疼痛、疲劳、焦虑和幸福感的显著改善。11名患者(44%)在最近一次按摩后30天内因疾病进展、疲劳和腹泻返回急诊科。25例患者均无因按摩引起的并发症。1例患者在完成按摩后7天再次发生静脉血栓栓塞(患者因假性动脉瘤出血停用抗凝治疗)。结论:我们的研究表明,如果采取预防措施,不按摩静脉血栓栓塞的解剖部位,患者发热,血小板>50,000,无凝血功能障碍,肿瘤按摩是一种安全,无创的干预措施,即使在静脉血栓栓塞后,也可以改善全身疼痛,疲劳和生活质量。
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The Efficacy and Safety of Massage Therapy for Cancer Inpatients with Venous Thromboembolism
Background: Cancer patients have a 4 to 7 fold increase in the frequency of Venous Thromboembolism (VTE) during treatment and VTE is a common cause of death. Oncology massage has been traditionally contraindicated in patients with thromboembolism, but studies show oncology massage improves symptoms and quality of life.Objectives: The purpose of this study was to review the safety and patient reported outcomes of massage in oncologic patients with a recent history of VTE.Methods: After obtaining UT MD Anderson institutional review board approval, 25 patients who received oncology massage for symptom relief and quality of life, following the diagnosis of VTE were retrospectively reviewed. Edmonton Symptom Assessment Scale (ESAS) scores were reviewed pre- and post-massage, as well as complications within 30 days requiring return to the Emergency Room or hospital re-admission.Results: 19 patients with complete ESAS scores reported a significant improvement in pain, fatigue, anxiety and well-being. Eleven patients (44%) returned to the emergency department within 30 days of their most recent massage, due to disease progression, fatigue and diarrhea. None of the 25 patients had complications due to massage. One patient experienced a new VTE 7 days after finishing massage, (patient was off anti-coagulation secondary to a pseudoaneurysm bleed).Conclusions: Our study suggests that if precautions are taken not to massage the anatomic site of the VTE, patients are afebrile and have >50,000 platelets with no coagulopathy, oncologic massage is a safe, non-invasive intervention even following VTE for improvement in generalized pain, fatigue and quality of life.
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