论文部分内容阅读
目的:比较各种因素对喉癌患者术后生存质量的影响。方法:回顾性分析行手术治疗的303例喉癌患者,采用中文版(EORTC)QLQ-C30(V3.0)及QLQ-H&N35生存质量问卷进行评估,比较各因素与喉癌术后患者生存质量的关系。结果:303例患者中目前仍保留气管造瘘者78例(其中全喉切除59例,部分喉切除19例);4例仍带鼻饲管。女性患者在躯体功能、总健康状况等方面不如男性(P<0.05)。高龄患者较低龄患者躯体功能及语言能力差(P<0.05)。声门型患者总健康状况最好,而吞咽问题方面声门上型最差。临床晚期(Ⅲ、Ⅳ期)患者在多个领域得分不如临床早期(Ⅰ、Ⅱ期)患者,Ⅲ期患者比Ⅳ期患者吞咽问题更明显。微创手术及喉裂开声带切除术比部分及全喉切除者生存质量好。部分喉切除者在躯体功能、情绪功能、总健康状况、感觉、语言、咳嗽、病态感、进食管等领域比全喉切除者好,但在疲倦、疼痛、气促、吞咽、口干、唾液黏稠领域不如后者;而水平部分喉切除者吞咽问题明显。术式是影响语言功能的独立因素。手术同期行颈廓清者比未做颈廓清者有更多的不适症状。有气管造瘘者在生存质量的多个领域明显差于无气管造瘘者,且是语言功能和总健康状况领域的独立影响因素。结论:各临床特征影响不同的生存质量领域。术式是影响语言功能的独立因素。是否有气管造瘘是影响总健康状况的重要因素。
Objective: To compare the impact of various factors on the quality of life of patients with laryngeal cancer. Methods: A total of 303 laryngeal cancer patients undergoing surgical treatment were retrospectively analyzed. EORTC QLQ-C30 (V3.0) and QLQ-H & N35 quality of life questionnaire were used to assess the quality of life of patients with laryngeal cancer Relationship. Results: Of the 303 patients, 78 cases of tracheostomy were retained (including 59 cases of total laryngectomy and 19 cases of partial laryngectomy), and 4 cases still had nasogastric tube. Female patients were inferior to men in physical function and general health (P <0.05). The elderly patients with lower body function and poor language ability (P <0.05). Patients with glottic type had the highest total health status, while those with swallowing problems had the worst supraglottic type. Patients in the advanced stage (stage III and IV) scored worse than those in the early stage (stages I and II) in multiple fields. Stage III patients had more swallowing problems than stage IV patients. Minimally invasive surgery and laryngectomy open vocal cord resection than partial and total laryngectomy good quality of life. Some laryngectomies are better than total laryngectomy in the areas of physical function, emotional function, general health status, sensation, language, cough, morbidity, and esophageal feeding, but they are more effective than total laryngectomy in tiredness, pain, shortness of breath, swallowing, Viscous field is not as good as the latter; while the level of partial laryngectomy swallowing problem is obvious. Surgery is an independent factor that affects language function. Surgical neck dissection over the same period did not do more than the neck clear who have symptoms of discomfort. Tracheostomy patients are significantly worse at tracheostomy in several areas of quality of life and are independent contributors to both language function and general health status. CONCLUSIONS: Each clinical characteristic affects different areas of quality of life. Surgery is an independent factor that affects language function. Whether or not tracheostomy is an important factor affecting the overall health status.