肺癌患者术后短期生活质量影响因素的研究

发布时间：2018-11-14 14:26

【摘要】：目的：手术切除是目前治疗非小细胞肺癌,延长患者生存时间的最重要手段。随着CT筛查越来越普遍,将出现越来越多新发现的早期肺癌患者。术后生存质量作为治疗效果的评价标准之一也越来越受到重视。本文旨在研究：(1)肺癌手术是否会对患者生活质量产生显著的影响,其影响主要涉及生活质量的哪些维度；(2)筛选对肺切除术后患者生活质量各维度有显著影响的因素。从而可以术前识别术后生活质量显著下降的患者,并对其做针对性的治疗而提高其术后生活质量。方法：本文采用前瞻性的研究方法,连续纳入满足条件的患者共28人,使用SF-36中文版量表对患者术前及术后2个月的生活质量进行评估。并对可能影响患者术后生活质量的影响因素(如性别、年龄、吸烟史、BMI、是否患有系统性疾病、肺功能、手术术式、是否微创手术、肿瘤分化程度、TNM分期等)进行了筛查。使用配对t检验、逻辑回归分析方法对数据进行分析处理。结果与结论：本研究证实了肺癌术后短期内患者生活质量在生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能7个维度中有明显的下降,精神健康维度下降并没有达到显著水平。而在对可能影响患者术后生活质量的因素研究中,发现术前肺功能仅对术后生理机能维度有显著的影响,其他因素,包括性别、年龄、吸烟史、BMI、术前是否存在系统性疾病、术式、切除范围、组织学类型、术后病理分期,对患者术后生活质量各维度均没有显著影响。
[Abstract]:Objective: surgical resection is the most important method to treat non-small cell lung cancer and prolong the survival time. As CT screening becomes more and more common, there will be more and more newly discovered early lung cancer patients. The quality of life after operation as one of the evaluation criteria of therapeutic effect has been paid more and more attention. The purpose of this paper is to study: (1) whether lung cancer surgery will have a significant impact on the quality of life of patients, and which dimensions of the quality of life are involved; (2) screening the factors that have significant influence on the quality of life of patients after pneumonectomy. Therefore, the quality of life after operation can be improved by identifying the patients who have significantly decreased their quality of life before operation and doing targeted treatment. Methods: a prospective study was conducted to evaluate the quality of life (QOL) of 28 patients before and 2 months after operation with the Chinese version of SF-36. The factors affecting the quality of life (such as sex, age, smoking history, BMI, pulmonary function, surgical procedure, minimally invasive operation, tumor differentiation, TNM stage, etc.) were screened. The paired t test and logistic regression analysis were used to analyze and process the data. Results & conclusion: this study confirmed that the quality of life of patients with lung cancer decreased significantly in seven dimensions: physiological function, physical pain, general health status, energy, social function and emotional function. The decline in mental health dimensions was not significant. In the study of factors that may affect the quality of life of patients after operation, it was found that preoperative pulmonary function had a significant effect on the postoperative physiological functional dimensions. Other factors, including sex, age, smoking history, and whether there was a systemic disease before BMI, were found. Surgical procedures, resection range, histological types, postoperative pathological stages, all dimensions of postoperative quality of life were not significantly affected.
【学位授予单位】：浙江大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R734.2

【共引文献】