影响乳腺癌患者选择乳房重建相关因素分析

发布时间：2018-05-14 08:44

本文选题：乳腺癌 + 乳房重建　；参考：《山西医科大学》2017年硕士论文

【摘要】：背景:多种因素影响着乳腺癌患者对乳房重建的选择。乳腺癌患者选择乳房重建与否,对其本身的社会心理有极大的影响。目前我省对乳腺癌患者选择乳房重建的影响因素知之甚少,本文目的旨在分析影响乳腺癌患者选择乳房重建的相关因素。材料方法:我们选择从2016年4月至2016年12月这一连续的时间段内在山西大医院乳腺外科诊治的乳腺癌患者为研究对象,包括:确诊为乳腺癌尚未行手术治疗的患者、乳腺癌术后治疗的患者、门诊复查的患者,共收集106名患者信息,内容包括:(1)基本信息。患者的出生年月、职业、文化程度、婚姻状况、家庭收入状况、住院费用报销类别、是否手术情况;(2)手术后患者情况。患者的手术治疗医院、手术医生是否介绍过“乳房重建”、术后时间、手术方式、是否行前哨淋巴结活检、是否行腋窝淋巴结清扫、病理分期及分型、术后是否有并发症、是否对自身形象是否满意、术后辅助治疗。(3)乳房重建相关问题。是否了解乳房重建、是否选择乳房重建、选择重建的时机及方式、不选择重建的原因。所收集数据采用SPSS19.0进行分析,年龄采用均数±标准差表示,计数资料采用例数(构成比)表示,涉及到的统计方法有t检验、卡方分析、多元logistic回归。结果:本研究共向106例患者发放调查问卷,回收有效问卷106份,问卷完成率为100%。患者年龄中位数为52岁(范围为23至76岁),平均年龄为51.24±11.12岁。在多变量分析中,我们将文化程度、家庭收入、手术治疗医院、手术方式、术后对自身满意度、年龄这六项有统计学意义的因素作为多因素分析的自变量,结果显示,仅有家庭收入、年龄及手术治疗医院类别与患者选择乳房重建有显著的相关性。家庭收入越多选择重建的概率越高,收入≥10000元的人相对于2000元的人选择重建的可能性是5.0倍(OR 5.0 95%CI 3.835-6.261 P=0.008);年龄52岁组相对于大于52岁组选择重建的可能性是1.3倍(OR 0.8 95%CI 0.706-0.870 P=0.008);在三甲综合性教学医院(OR 47.4 95%CI 44.686-50.040 P=0.005)治疗的患者相对其他患者选择乳房重建的概率越高,三级综合医院就医患者选择重建的可能性是其他医院的47.4倍。讨论:虽然近些年乳房重建率逐渐增高,但是选择乳房重建的患者仍然较少。本研究显示,年龄、家庭经济状况、患者接受手术治疗的医院类型是影响患者选择乳房重建的重要因素。
[Abstract]:Background: a variety of factors affect breast cancer patients' choice of breast reconstruction. Whether breast cancer patients choose breast reconstruction or not has great influence on their own social psychology. At present, we know very little about the influencing factors of breast reconstruction in breast cancer patients. The purpose of this paper is to analyze the related factors affecting breast cancer patients' choice of breast reconstruction. Materials: we selected breast cancer patients who had been diagnosed and treated in breast surgery in Shanxi Great Hospital from April 2016 to December 2016, including those diagnosed as breast cancer patients who had not received surgical treatment for breast cancer. A total of 106 patients with breast cancer treated after operation and outpatients with outpatient reexamination were collected, including the basic information of: 1). Year of birth, occupation, education, marital status, family income, category of reimbursement for hospital expenses, whether or not the operation was performed. The patient's surgical treatment hospital, surgeon has introduced "breast reconstruction", postoperative time, operation method, whether to perform sentinel lymph node biopsy, whether to perform axillary lymph node dissection, pathological stage and classification, and whether there are complications after operation. Whether satisfied with self-image, postoperative adjuvant treatment. 3) breast reconstruction related problems. Whether to understand breast reconstruction, whether to choose breast reconstruction, to choose the time and method of reconstruction, not to choose the reasons for reconstruction. The collected data are analyzed by SPSS19.0, the age is expressed by mean 卤standard deviation, and the counting data is expressed by examples (composition ratio). The statistical methods involved are t-test, chi-square analysis and multivariate logistic regression. Results: a total of 106 patients were investigated and 106 valid questionnaires were collected. The completion rate of the questionnaires was 100. The median age of the patients was 52 years (ranging from 23 to 76 years, mean age was 51.24 卤11.12 years). In the multivariate analysis, we used six factors, such as education level, family income, surgical treatment hospital, operation mode, postoperative satisfaction and age, as independent variables of multivariate analysis. Only family income, age and type of surgical treatment hospital were significantly correlated with patients' choice of breast reconstruction. The higher the household income, the more likely it is to choose to rebuild. The odds of people earning more than 10000 yuan to choose reconstruction were 5.0 times higher than those of 2000 yuan, OR 5.0 95%CI 3.835-6.261 P0.008, OR 0.8 95%CI 0.706-0.870 P0. 008; OR = 1.3-0.706-0.870 P0. 008; OR = 1.3x; OR = 0.706-0.870 P0. 008P; OR = 1.3x; OR = 0.706-0.870 P0. 008P; 47.4 95%CI 44.686-50.040 P0. 005) the higher the probability of breast reconstruction in patients treated with 95%CI 44.686-50.040 P0. 005, Patients in tertiary general hospitals are 47.4 times more likely to choose reconstruction than other hospitals. Discussion: although breast reconstruction rates have increased in recent years, fewer patients choose breast reconstruction. This study shows that age, family financial status, and the type of hospital in which patients receive surgical treatment are important factors affecting the choice of breast reconstruction.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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