甲状腺癌患者术后生存质量分析

发布时间：2018-03-07 13:07

  本文选题：甲状腺癌　切入点：手术治疗　出处：《浙江大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:研究甲状腺癌术后患者生存质量变化趋势并分析与其相关的潜在临床因素。方法:通过横断面研究调查于浙江大学医学院附属第一医院经手术确诊甲状腺癌并于门诊随访的患者的生存质量,描述性分析其生存质量随术后时间变化趋势,比较甲状腺癌行不同术式患者生存质量的差异,通过相关分析和多元回归分析研究各临床特征与患者术后生存质量的潜在相关性,并提出预测患者术后生存质量的临床变量。结果:甲状腺癌术后患者早期生存质量各领域有下降,乏力、失眠症状明显,后随着时间变化呈恢复趋势。甲状腺手术切除范围的扩大对患者术后生存质量没有明显影响。术后随访时间≤12月的患者在术后生存质量的情绪、社会功能领域、总体健康状况表现更差(P值分别为P=.002,P=.043和P=.006),失眠症状也更显著(P=.023)。术后随访时间亦与颈部不适(P=.000)、焦虑(P=.000)多个条目相关,术后12月内主诉上述症状明显,而随术后时间的变化症状得到改善。初次诊断时年龄≥45岁的患者与术后躯体功能、认知功能等多个领域功能的下降有显著相关(P值分别为P=.012,P=.049)。患者复发危险分层和血促甲状腺激素水平也与术后生存质量受损相关。女性相较男性表现出更明显的吞咽困难(P=.018)、术后焦虑(P=.002)和认为术后容貌改变(P=.010)。多变量分析中,术后随访时间是唯一与总体健康状况(P=.022)及多项症状条目相关的变量。结论:甲状腺癌患者术后早期生存质量下降,初次诊断时年龄大于45岁、中高复发危险、TSH水平控制不佳的患者与术后生存质量较差相关,而总体情况随时间变化呈恢复趋势。
[Abstract]:Objective: to study the trend of quality of life (QOL) in patients with thyroid cancer after operation and to analyze the potential clinical factors associated with it. Methods: the thyroid gland was confirmed by operation in the first affiliated Hospital of Zhejiang University Medical College by cross-sectional study. Quality of life of cancer patients followed up in outpatient clinics, The quality of life (QOL) of patients with thyroid cancer was compared with the trend of postoperative time, and the potential correlation between clinical features and postoperative quality of life was studied by correlation analysis and multivariate regression analysis. Results: the early quality of life of patients with thyroid cancer was decreased, fatigue and insomnia symptoms were obvious. The extent of thyroidectomy had no significant effect on the postoperative quality of life. The postoperative follow-up time 鈮，

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