肺癌患者术后并发症危险因素Logistic回归及生活质量分析

发布时间：2018-06-21 22:46

本文选题：肺癌 + 术后并发症　；参考：《新乡医学院》2015年硕士论文

【摘要】：目的：1.探讨肺癌术后出现并发症的危险因素,制定合理有效的预防措施。2.了解肺癌患者手术前后生活质量及其变化情况。方法：回顾性分析114例肺癌手术治疗的患者临床资料,其中36例出现术后并发症,对其危险因素做出单因素卡方检验和多因素logistic回归分析。采用QLQ-C30对患者QOL进行问卷调查。调查分别于术前3天及术后4周、12周进行。结果：1.114例肺癌术后出现并发症的有36(31.58%)例,危险因素单因素分析结果显示年龄、冠心病、糖尿病、慢性阻塞性肺部疾病、吸烟史、烟龄、于术持续时间、FEV%有统计学意义(P0.05)。危险因素多因素Logistic回归分析结果显示年龄(OR=13.824,95%CI 2.637-71.500)、冠心病(OR=10.800,95%CI2.309～50.510)、慢性阻塞性肺部疾病(OR=4.267,95%CI 1.060-17.183)、烟龄(OR=8.517,95%CI2.457-29.523)是并发症的危险因素(P0.05)。2.肺癌术后生活质量较低,术后3个月基本恢复术前水平。角色功能下降幅度最为明显,术后3个月除社会功能外,其他各功能领域及总健康状况均有所上升,与术前水平接近。对于疼痛、疲倦等症状指标,术后1个月均有不同程度的上升,术后3个月逐渐恢复。101例患者手术前生命质量在认知功能领域得分最高,为72.77±15.04,在功能领域,手术后1个月较术前均有所降低,术后3个月有所恢复,不同时间段肺癌患者生活质量功能领域比较均具有统计学意义(P0.05)；在症状领域,恶心呕吐及腹泻症状术前得分最低,分别为8.75±14.26、9.57±15.87；术后有所升高；除气促、便秘、腹泻三个时间段进行比较无统计学意义外,其他症状(疲倦、恶心呕吐、失眠、疼痛、食欲丧失)均具有统计学意义。结论：1.肺癌手术患者术后出现并发症的发生率很高,年龄、烟龄、冠心病和慢性阻塞性肺部疾病是并发症的高危因素。2.并发症严重降低病人的生活质量,应该针对这些危险因素找到相应的预防措施,尽可能降低风险。
[Abstract]:Purpose 1. To explore the risk factors of postoperative complications of lung cancer and to formulate reasonable and effective preventive measures. 2. Objective: to investigate the quality of life and its changes in patients with lung cancer before and after operation. Methods: the clinical data of 114 patients with lung cancer undergoing surgical treatment were retrospectively analyzed. Among them, 36 cases had postoperative complications. The risk factors were analyzed by single factor chi-square test and multivariate logistic regression analysis. QLQ-C 30 was used to investigate QOL. The investigation was conducted 3 days before operation and 12 weeks after operation. Results 36 (31.58%) cases of lung cancer had complications after operation. Age, coronary heart disease, diabetes, chronic obstructive pulmonary disease, smoking history, smoking age and FEV% were statistically significant (P0.05). Multivariate logistic regression analysis showed that age (OR 13.824 CI 2.637-71.500), coronary heart disease (OR 10.800), chronic obstructive pulmonary disease (OR 4.267 ~ 95CI 1.060-17.183), smoking age (OR8.51795CI2.457-29.523) were risk factors of complications (P0.05). The quality of life of lung cancer was lower after operation, and the preoperative level was basically restored 3 months after operation. The decrease of role function was the most obvious, except for social function, the other functional areas and the total health status were all increased in 3 months after operation, which were close to the preoperative level. For symptoms such as pain, fatigue and so on, there were different degrees of increase at one month after operation. The scores of life quality of 101 patients before operation were the highest (72.77 卤15.04) in the field of cognitive function 3 months after operation, and gradually recovered at 3 months after operation, and the scores of QOL in cognitive function were the highest (72.77 卤15.04). One month after surgery compared with the preoperative decreased, 3 months after the recovery, different time of lung cancer patients with quality of life functional areas were statistically significant (P0.05); in the symptom area, nausea and vomiting and diarrhea symptoms before the lowest score, There was no significant difference in other symptoms (fatigue, nausea and vomiting, insomnia, pain, loss of appetite) except for shortness of breath, constipation and diarrhea. Conclusion 1. The incidence of postoperative complications in patients with lung cancer is high. Age, coronary heart disease and chronic obstructive pulmonary disease are high risk factors for complications. The complication seriously reduces the patient's quality of life, should find the corresponding prevention measure to these risk factors, reduce the risk as far as possible.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R734.2

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