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目的采用EORTC-QLQ-C30(V3.0)中文版生活质量核心调查量表,问卷式调查评估微创胸腹腔置管引流术并腔内灌注甘露聚糖肽治疗方法对晚期恶性胸腹腔水(MPPE)癌症患者生活质量的影响。方法从2003年10月～2008年2月间,应用EORTC-QLQ-C30(V3.0)量表对69例接受该方法治疗的MPPE癌症患者进行了生活质量调查研究和评估。入组患者机体机能状况差,中位KPS评分40分,问卷式调查在治疗前和治疗后1个月进行。结果治疗后患者EORTC-QLQ-C30(V3.0)核心量表15项领域功能子量表中躯体功能、情绪功能和整体健康状况/生活质量标准分(SS)均有明显的提高,分别由21.11±7.74,41.17±13.98,23.56±19.42提高到42.94±29.56,50.00±18.18,64.11±12.01(P<0.01,P<0.05,P<0.01),差值有显著性统计学意义,改善率分别为71.01%,50.73%和72.46%。症状子量表和单项项目中,除便秘、腹泻单项SS治疗前后没有明显改变外,乏力、恶心/恶吐、疼痛、气短、失眠、食欲减弱SS均明显降低(P<0.05～P<0.01),改善率分别为69.57%,39.13%,68.12%,88.41%,47.83%和37.68%。经济困难者SS则明显升高(P<0.05),改善率仅为2.90%。胸腹水控制有23例CR(33.33%),37例PR(53.62%),6例NC(8.70%),3例PC(4.35%),总有效率为86.96%(60/69)。KPS评分由44.90±13.17提高到64.11±12.01(P<0.01),改善率为78.26%。结论中心静脉导管微创胸腹腔置管引流联合甘露聚糖肽腔内灌注治疗晚期MPPE,可以明显改善和提高MPPE患者的QOL水平,临床疗效较好,值得临床推广应用。
Objective To evaluate the efficacy of EORTC-QLQ-C30 (V3.0) Chinese version of the Quality of Life Core Survey, questionnaire survey to evaluate the minimally invasive thoracic and abdominal drainage and intraluminal perfusion of mannan peptide in patients with advanced malignant pleural and peritoneal water ( MPPE) cancer patients quality of life. Methods From October 2003 to February 2008, 69 patients with MPPE treated by this method were investigated for quality of life by EORTC-QLQ-C30 (V3.0) scale. Patients in the group had poor functional status with a median KPS score of 40, and questionnaires were administered before treatment and one month after treatment. Results After treatment, the body function, emotional function and overall health status / quality of life standard score (SS) of 15 field subscales of EORTC-QLQ-C30 (V3.0) 21.11 ± 7.74,41.17 ± 13.98,23.56 ± 19.42 to 42.94 ± 29.56,50.00 ± 18.18,64.11 ± 12.01 (P <0.01, P <0.05, P <0.01), the differences were statistically significant 71.01%, 50.73% and 72.46% respectively. Symptom subscale and single item, except for constipation, diarrhea, single SS treatment before and after no significant change, fatigue, nausea / vomiting, pain, shortness of breath, insomnia, loss of appetite decreased SS were significantly lower (P < The improvement rates were 69.57%, 39.13%, 68.12%, 88.41%, 47.83% and 37.68% respectively. The SS of economic difficulties were significantly higher (P <0.05), the improvement rate was only 2.90%. Thoracic and ascites fluid control in 23 cases of CR (33.33%), 37 cases of PR (53.62%), 6 cases of NC (8.70%), 3 cases of PC (4.35%), the total effective rate was 86.96% (60/69). KPS score increased from 44.90 ± 13.17 to 64.11 ± 12.01 (P <0.01), the improvement rate was 78.26%. Conclusion Central venous catheter minimally invasive thoracic and abdominal drainage tube combined mannan oligopeptide endovascular treatment of advanced MPPE, can significantly improve and improve QOL levels in patients with MPPE, clinical efficacy is good, worthy of clinical application.