预先指示与生命终端的侵入性生命支持使用之间的关联:回顾性队列研究
Zheng-Hui Wang1, Yan Huang1, Tian-Feng Zhang1
1Department of Cardiovascular Medicine, The People's Hospital Affiliated to Jiangsu University, Zhenjiang 212000, Jiangsu, China.
Journal of pain and symptom management
|February 28, 2026
概括
预先指示 (ADs) 显著减少了生命终端护理中的侵入性生命支持使用. 有文件的助理确保尊重患者的偏好,防止侵略性干预,特别是在夜间紧急情况下.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 医学伦理 医学伦理
背景情况:
- 侵入性生命支持经常用于终身护理.
- 紧急决策往往与患者和家人的生命末期偏好相冲突.
研究的目的:
- 调查预先指示 (ADs) 与侵入性生命支持的利用之间的关联.
- 为了确定已记录的AD是否会影响内管道输入和胸部压缩的使用.
主要方法:
- 一项回顾性队列研究分析了139名已故心脏病护理单位患者的数据.
- 如果患者死于心脏病原因,则包括患者,但不包括手术期间或早期入院死亡.
主要成果:
- 预先指示 (ADs) 患者的接受内内管和胸部压缩的几率显著降低 (P < 0.001).
- 年龄较大和心力衰竭史与输管减少有关.
- 与白天死亡 (36.8%) 相比,夜间死亡与更高的输管率 (56.3%) 有关.
结论:
- 明确记录的ADS独立地与侵袭性生命支持的减少有关.
- 夜间死亡成为积极复苏的风险因素,表明系统偏差.
- 对AD记录和访问的系统程序对于将终身护理与患者的愿望保持一致至关重要.
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