行经皮肝动脉化疗栓塞术的肝癌患者癌因性疲乏与生存质量、希望水平的相关性研究

发布时间：2018-05-21 16:44

本文选题：经皮肝动脉化疗栓塞术 + 肝癌　；参考：《大连医科大学》2016年硕士论文

【摘要】：目的:调查行经皮肝动脉化疗栓塞术的肝癌患者癌因性疲乏水平及程度;了解影响癌因性疲乏的因素;并探讨行经皮肝动脉化疗栓塞肝癌患者的生存质量、希望水平与癌因性疲乏之间的相关性。方法:应用便利抽样方法,采用一般资料调查表、癌因性疲乏量表、生存质量量表、希望水平量表和应对方式量表,对135例在大连市某三级甲等医院行经皮肝动脉化疗栓塞术的肝癌患者进行调查。采用SPSS17.0统计软件对数据进行统计分析。结果:1.行经皮肝动脉化疗栓塞术的肝癌患者癌因性疲乏总体得分为(32.79±6.65)分,为中度疲乏。其中“躯体疲乏”得分为(14.19±5.04)分,“情感”、“认知”疲乏各维度得分分别为(11.20±2.41)分、(5.46±2.05)分。其中,躯体疲乏领域中“觉得自己容易疲劳”条目得分最高为(4.10±1.09);情感疲乏领域中“集中注意力”条目得分最高为(3.16±1.02);认知疲乏领域中“记忆力下降”条目得分最高为(2.83±1.64);2.单因素分析结果显示:年龄、性别、婚姻状况、乙肝、肝硬化病史、接受行肝动脉化疗栓塞术的次数整体疲乏差异无统计学意义(P0.05);文化程度、经济压力、医疗费用来源、希望水平以及生存质量为行经皮肝动脉化疗栓塞术肝癌患者癌因性疲乏的影响因素,结果有统计学意义(P0.05);3.行经皮肝动脉化疗栓塞术的肝癌患者生存质量总体得分为(61.16±14.12)分,各维度从高到低得分依次为:社会/家庭状况(17.84±3.39)、身体状态(16.55±5.55)、功能状况(14.41±4.58)以及情绪状况(12.36±4.69)。其中,在身体状态维度“感到恶心”得分最高为(3.02±1.15),“体力不足”得分最低为(1.45±1.35);社会/家庭维度“家庭了解及接受疾病”得分最高为(3.60±0.55),“和朋友关系密切度”得分最低为(2.13±1.15),情绪状况维度“对战胜疾病失去信心”得分最高为(2.64±1.02),“担心病情进一步恶化”得分最低为(1.74±1.09);功能状况维度“能接受自身疾病”得分最高为(3.27±0.95),“睡眠情况”得分最低为(1.27±0.94)分;经皮肝动脉化疗栓塞术的肝癌患者癌因性疲乏程度与生存质量总体及其各维度均呈负相关(r=-0.513、-0.410、-0.198、-0.392、-0.526,P0.05);4.行经皮肝动脉化疗栓塞术肝癌患者希望水平总分是(32.36±5.51)分,处中等水平。各维度得分从高到低依次为:采取积极行动(11.46±1.89)分、与他人保持亲密关系(11.04±2.06)分、对现实和未来的积极态度(9.86±2.02)分;与癌因性疲乏总体及其各维度呈负相关(r=-0.278、-0.339、-0.365、-0.825,P0.05)5.行经皮肝动脉化疗栓塞术的肝癌患者应对方式总分为(44.44±6.56)分,其中“面对”、“回避”、“屈服”各维度得分分别为(17.39±4.45)分、(15.83±2.56)分、(11.22±3.11)。癌因性疲乏总体及各维度领域与应对方式“面对”、“回避”与呈负相关(r=-0.395、-0.274,P0.01);与“屈服”应对方式呈正相关(r=0.172,P0.05)。结论:1.行经皮肝动脉化疗栓塞术的肝癌患者癌因性疲乏程度、生存质量和希望水平均呈中等水平;2.文化程度、家庭经济压力、医疗费用来源、希望水平、生存质量是行经皮肝动脉化疗栓塞术的肝癌患者癌因性疲乏的主要影响因素;3.行经皮肝动脉化疗栓塞术的肝癌患者癌因性疲乏与希望水平、生存质量、“面对”“回避”应对方式呈负相关,与“屈服”应对方式呈正相关。护理人员应从提高患者希望水平、生存质量角度出发,采取针对性措施,从而改善行经皮肝动脉化疗栓塞术的肝癌患者癌因性疲乏程度。
[Abstract]:Objective: To investigate the level and degree of cancer induced fatigue in patients with hepatocellular carcinoma by transcatheter arterial chemoembolization (TACE), to understand the factors affecting the cancer induced fatigue, and to explore the correlation between the quality of life of the patients with liver cancer by transcatheter hepatic arterial chemoembolization and the correlation between the hope level and the cancer induced fatigue. Table, cancerous fatigue scale, quality of life scale, hope level scale and coping style scale, 135 cases of liver cancer patients undergoing transcatheter hepatic arterial chemoembolization in a class three grade a hospital in Dalian were investigated. The data were statistically analyzed by SPSS17.0 software. Results: 1. lines of transcatheter hepatic arterial chemoembolization were performed in 1. cases. The total score of cancer induced fatigue was (32.79 + 6.65) and was moderate fatigue. The score of "body fatigue" was (14.19 + 5.04), and the scores of "emotion" and "cognitive" fatigue were (11.20 + 2.41) and (5.46 + 2.05) respectively. Among them, the highest score was (4.10 + 1.09) in the field of physical fatigue (4.10 + 1.09). The highest score of "concentration" items was (3.16 + 1.02), and the highest score of "memory decline" in cognitive fatigue was (2.83 + 1.64). 2. single factor analysis showed that there was no statistical difference between age, sex, marital status, hepatitis B, liver cirrhosis, and hepatic arterial chemoembolization. Learning significance (P0.05); cultural degree, economic pressure, medical cost source, level of hope and quality of life were the factors affecting cancer induced fatigue in patients with liver cancer by transcatheter arterial chemoembolization (P0.05); the total score of the 3. lines of liver cancer patients with percutaneous hepatic arterial chemoembolization was (61.16 + 14.12) scores. The scores from high to low were: social / family status (17.84 + 3.39), physical state (16.55 + 5.55), functional status (14.41 + 4.58) and emotional state (12.36 + 4.69). Among them, the highest score of "feeling nausea" in the physical state dimension was (3.02 + 1.15), and the lowest score was (1.45 + 1.35); social / family dimension "home". The highest score was (3.60 + 0.55) and the lowest score was (2.13 + 1.15). The highest score was (2.64 + 1.02) and the lowest score of "fear of further deterioration" was (1.74 + 1.09), and the function condition dimension could accept the disease. The highest score was (3.27 + 0.95) and the lowest score of "sleep condition" was (1.27 + 0.94). The degree of cancer induced fatigue in patients with liver cancer by transcatheter arterial chemoembolization was negatively correlated with the overall quality of life and its dimensions (r=-0.513, -0.410, -0.198, -0.392, -0.526, P0.05); 4. lines of transcatheter hepatic arterial chemoembolization were hoped for the level of liver cancer. The total score was (32.36 + 5.51). The scores from high to low were: positive action (11.46 + 1.89), close relationship with others (11.04 + 2.06), positive attitude to reality and future (9.86 + 2.02); negative correlation with cancer related fatigue body and its dimensions (r=-0.278, -0.339, -0.365, -0.825, P0.05) 5. The total score of the coping style of liver cancer patients undergoing transcatheter hepatic arterial chemoembolization was (44.44 + 6.56). The scores of "face" and "avoidance" were (17.39 + 4.45), (15.83 + 2.56), (11.22 + 3.11), respectively (15.83 + 2.56), and (11.22 + 3.11). -0.395, -0.274, P0.01) and a positive correlation with the "yield" coping style (r=0.172, P0.05). Conclusion: 1. lines of transcatheter hepatic arterial chemoembolization have moderate level of cancer induced fatigue, quality of life and hope level; 2. cultural degree, family economic pressure, medical cost source, hope level, and quality of life are transdermal liver movement. The main factors affecting cancer induced fatigue in patients with hepatocellular carcinoma with pulse chemotherapy embolization; 3. lines of percutaneous hepatic arterial chemoembolization in patients with cancer induced fatigue are negatively related to the level of hope, the quality of life, the "face" "avoidance" coping style, and a positive correlation with the "yield" coping style. From the perspective of quality of life, targeted measures should be taken to improve the degree of cancer-related fatigue in patients with hepatocellular carcinoma undergoing percutaneous transcatheter arterial chemoembolization.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R473.73

【参考文献】