全科团队下临终期肿瘤安宁疗护的系统评价与荟萃分析

Background: Community intervention is an important part of palliative care for advanced cancer. However, there is little literature to study its role in the health management of patients with advanced cancer in recent years. Objective: To evaluate the efficacy of palliative care for advanced cancer based on community resource. Methods: Cochrane system evaluation method was used to search Cochrane Library, PubMedWeb of ScienceChina Online Journals(COJ),CNKI and Cqvip databases with "Community-based", "Model of palliative care","Bilateral-referral", "Advanced Cancer" and "Quality of life" in both English and Chinese, The quality of randomized controlled trials meeting the inclusion criteria was evaluated, and the effective information was extracted for Meta-analysis. Results: A total of 12 RCTs were included in the study, involving 2640 patients. Meta-analysis showed that early palliative care (EPC) could improve the quality of life of patients with advanced cancer compared with conventional cancer treatment, reduce the degree of symptoms, but failed to improve depressive symptoms, and did not reduce their admission rate. Otherwise, its impact on the number of hospitalization days, the rate of emergency treatment and other related indicators of health economics needs to be further confirmed. Different models of palliative care should be adapted to national conditions and circumstances.Conclusion: EPC for advanced cancer based on community resource can improve the quality of life and symptom severity of patients with advanced cancer, while its role in improving depression, improving survival rate and reducing medical cost needs to be further confirmed.