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中华临床医师杂志(电子版) ›› 2025, Vol. 19 ›› Issue (03) : 165 -179. doi: 10.3877/cma.j.issn.1674-0785.2025.03.001

专家共识

肿瘤康复专家共识(2025)
肿瘤康复专家共识编写专家组   
  • 收稿日期:2025-03-25 出版日期:2025-03-15

Expert Consensus on Cancer Rehabilitation (2025)

Panel for the Development of Cancer Rehabilitation Consensus Expert   

  • Received:2025-03-25 Published:2025-03-15
引用本文:

肿瘤康复专家共识编写专家组. 肿瘤康复专家共识(2025)[J/OL]. 中华临床医师杂志(电子版), 2025, 19(03): 165-179.

Panel for the Development of Cancer Rehabilitation Consensus Expert. Expert Consensus on Cancer Rehabilitation (2025)[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2025, 19(03): 165-179.

肿瘤康复已成为提升患者生存质量、减少治疗副作用和促进功能恢复的重要环节。本共识基于全球最新研究与实践经验,提出了肿瘤康复的系统评估标准和干预策略。共识制定采用德尔菲会议法,由多学科专家组基于国际指南、系统评价、随机对照临床实验等证据,结合专家意见,制定了科学、可行的康复策略。共识明确了肿瘤康复的适用人群及目标,强调康复应贯穿治疗全周期即包括治疗前的预康复、治疗期的康复干预及长期康复。在评估方面,推荐采用国际功能、残疾和健康分类框架,全面评估患者的身体结构与功能、活动能力和参与水平及环境因素,并提出标准化评估工具建议。在干预方面本共识提出了包括运动处方、营养处方、药物处方、心理处方和舒缓处方在内的肿瘤康复的五大处方。此外,共识强调多学科团队(MDT)在肿瘤康复中的核心作用,建议建立动态评估与沟通机制,以优化康复方案并提高康复效果。

Cancer rehabilitation has become a critical component in improving patients' quality of life,reducing treatment side effects,and promoting functional recovery.This consensus,grounded in the latest global research and clinical practices,establishes systematic assessment criteria and intervention strategies for cancer rehabilitation.The consensus was developed using the Delphi method,with a multidisciplinary expert panel integrating evidence from international guidelines,systematic reviews,randomized controlled trials,and expert opinions to formulate scientifically robust and clinically feasible rehabilitation strategies.The consensus defines the target population and objectives of cancer rehabilitation,emphasizing that rehabilitation should span the entire treatment continuum,including prehabilitation before treatment,rehabilitation interventions during therapy,and long-term recovery.For assessments,the consensus recommends adopting the International Classification of Functioning,Disability,and Health framework to comprehensively evaluate patients' body structure/function,activity and participation levels,and environmental factors,alongside proposing standardized assessment tools.For interventions,the consensus outlines “Five Core Prescriptions for Cancer Rehabilitation”: exercise,nutrition,medication,psychological support,and palliative care.Additionally,it highlights the pivotal role of multidisciplinary teams in cancer rehabilitation,advocating for dynamic assessment and communication mechanisms to optimize rehabilitation protocols and enhance outcomes.

续表
评定内容 评定方法
全身症状 安德森症状量表(MDASI)[63]
埃德蒙顿症状评估量表(ESAS) [64]
疼痛 疼痛视觉模拟评估量表(VAS)[4]
问诊、触诊以及特定临床检查等体格检查方式[3]
疲劳 疲劳视觉模拟评估量表(VAS)[4]
多维疲乏量表(MFI-20)[4]
水肿 视诊、体表触诊、肢体围度测量等体格检查判断[3]
认知功能 简易精神状态评价量表(MMSE)[65]
蒙特利尔认知评估量表(MoCA)[65]
霍普金斯词语学习测试修订(HVLT-R)[66]
受控口头词语联想测试( COWA)[66]
连线测试(TM)[66]
吞咽功能 临床评估如:洼田饮水试验(Water Swallow Test)[67]
仪器评估如: 吞咽造影检查(Video-fluoroscopic Swallowing Study)[67]
睡眠功能 匹兹堡睡眠质量指数(PSQI)[68]
心理功能 汉密尔顿焦虑量表(HAMA)[69]
汉密尔顿抑郁量表(HAMD)[69]
焦虑自评量表(SAS)[68]
抑郁自评量表(SDS)[68]
患者健康问卷 9 项(PHQ-9)[22]
贝克抑郁量表 II(BDI-II)[22]
广泛性焦虑障碍量表(GAD-7)[22]
医院焦虑抑郁量表(HADS)[22]
症状自评量表(SCL-90)
创伤后应激障碍量表(Post-Traumatic Stress Disorder Scale)
心理弹性评估工具:如Connor-Davidson Resilience Scale (CD-RISC-10)、Resilience Scale Specific to Cancer(RS-SC)等
运动功能 肌力检查(徒手肌力测试、握力计及等速肌力测试等)[3]
关节活动度检查[70]
平衡功能与步态 Berg 平衡量表[3]
三维步态分析[3]
跌倒风险评估[3]
心肺功能 6 分钟步行试验[71]
心肺运动试验(CPET)[72]
血管功能 血管运动舒缩症状(VMS)评估[3]
消化系统与泌尿系统功能 尿液、粪便的实验室检查[3]
消化道造影检查[3]
泌尿系超声检查或尿动力检查[3]
生殖功能 生殖器官及功能相关检验检查[3]
营养功能 体质指数(BMI)[3-4]
营养不良通用筛查工具(MUST)[4]
身体成分测定[73]
评定内容 评定方法
活动能力 ECOG 评分标准[74]
Karnofsky 功能状态评分标准(KPS)[75]
参与水平 肿瘤患者自我感受负担量表(SPBSCP)[76]
癌症患者未满足需求简明量表(SF-SUNS)[77]
患者参与文化评估量表-医护版(PaCT-HCW)[78]
职业与教育评估(访谈法)[3]
生活质量 癌症治疗功能评价系统(FACT)[79]
36 项健康状况调查简表(SF-S6)[68]
背景因素 癌症及衰老研究组化疗风险评估量表(CARG)[80]
老年化疗风险评估量表(CRASH)[4,80]
老年筛查工具-8(G-8)[81]
老年人衰弱调查-13(VES-13)[4,82]
临床衰弱量表(CFS)[83]
身体成分测定[73]
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你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?