莱芜地区尘肺生存质量评价
发布时间:2018-01-24 11:38
本文关键词: 尘肺 生存质量 生存分析 共病 评价 出处:《武汉科技大学》2012年硕士论文 论文类型:学位论文
【摘要】:目的 探讨尘肺患者不同期别生存年限的差异,研究共病对尘肺生存质量的影响,为制定积极有效的医疗保健措施,进一步完善伤残鉴定标准,延长患者寿命、提高生命质量提供标准和科学依据。拓展尘肺生存质量的评价指标,力求建立全面科学的评价体系。 方法 对莱芜地区281例尘肺患者资料采用寿命表法和Kaplan-Meier法计算生存率,多因素分析采用Cox比例风险模型筛选影响预后因素,P0.05为差异有统计学意义。190例存活尘肺患者中,对150例进行了肺功能评价、营养状况评价、共病分析,并就生存质量和诸因素作回归分析。 结果 尘肺累积中位数生存时间为19.18年,叁期尘肺患者的生存时间较壹期和贰期短,尘肺期别、合并症和共病分别是尘肺生存时间的独立影响因子。老年尘肺患者中以中度肺功能不全者居多,占43.3%,有88.7%的患者存在不同程度的肺功能损害。生存质量与共病、营养状况之间存在相关关系。利用回归方程建立了生存质量与FVC、MEF75%、FEV1%、营养分、共病分五项指标之间的关系。随着肺功能损伤的加重,营养状况存在下降趋势,其中亚营养不良居多。通过方差分析,,认为在营养状况方面,肺功能重度损害者与正常者之间存在显著性差异。逐步拟合回归方程为:Y=0.710+0.350X_1+0.161X_2+0.209X_3(X_1代表年龄等级,X_2代表肺功能等级,X_3代表营养状况等级) 结论 共病方法在尘肺评价中切实可行,意义重大。共病分级以中度居多,无共病者最少,大多数人都存在着不同程度的其他疾病。积极治疗共病、预防或减少合并症是延缓尘肺晋期、延长生存时间的关键。尘肺生存质量的多因素评价科学有效。
[Abstract]:Purpose To explore the difference of life span of pneumoconiosis patients in different periods, to study the influence of co-disease on the quality of life of pneumoconiosis, to establish positive and effective medical and health care measures, to further improve the standard of disability identification, and to prolong the life span of patients with pneumoconiosis. To improve the quality of life to provide the standard and scientific basis to expand the quality of life of pneumoconiosis evaluation indicators and strive to establish a comprehensive and scientific evaluation system. Method The survival rate of 281 patients with pneumoconiosis in Laiwu area was calculated by life table method and Kaplan-Meier method. The prognostic factors were screened by Cox proportional risk model in multivariate analysis. The difference was statistically significant (P0.05) among 190 patients with surviving pneumoconiosis, 150 cases were evaluated with pulmonary function, nutritional status, co-disease analysis, and regression analysis was made on the quality of life and various factors. Results The median survival time of pneumoconiosis was 19.18 years. The survival time of patients with stage 3 pneumoconiosis was shorter than that of stage 1 and stage 2, and the stage of pneumoconiosis was different. Complications and syndromes were independent factors of survival time of pneumoconiosis. Moderate pulmonary insufficiency was the most common factor in elderly patients with pneumoconiosis, accounting for 43.3%. 88.7% of the patients had different degrees of lung function damage. There was a correlation between quality of life and co-disease and nutritional status. The regression equation was used to establish the relationship between quality of life and FVC MEF 75%. FEV1, nutritional score, total disease of the relationship between the five indicators. With the exacerbation of lung function injury, nutritional status has a downward trend, in which submalnutrition is the majority. Through ANOVA. In terms of nutritional status. There was significant difference between the patients with severe lung function damage and the normal subjects. The stepwise fitting regression equation was: 1: YY0.710 0.350X1 0.161XS 20. 209X3 (. X1 represents the age class. X2 for lung function grade X3 for nutritional status) Conclusion The method of comorbidity is feasible and significant in the evaluation of pneumoconiosis. The degree of comorbid diseases is mostly moderate and the least is non-comorbid. Most people have other diseases of different degrees. Prevention or reduction of complications is the key to delay the stage of pneumoconiosis and prolong the survival time. Multi-factor evaluation of pneumoconiosis quality of life is scientific and effective.
【学位授予单位】:武汉科技大学
【学位级别】:硕士
【学位授予年份】:2012
【分类号】:R135.2
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