喉切除术后患者生存质量的调查及分析

Evaluation and analysis of quality of life in patients following laryngectomy

目的探讨喉切除术后患者的生存质量及其影响因素。方法对42例喉全切除术和93例喉部分切除术患者进行调查问卷,问卷包括华盛顿医科大学生存质量量表、欧洲肿瘤研究及治疗组织的头颈癌调查表和医院焦虑抑郁情绪测定。结果 3年生存率为73.33%,Ⅰ、Ⅱ期生存率和生存质量均明显高于Ⅲ、Ⅳ期(P<0.01);喉部分切除组患者的生存质量总分、说话交流、娱乐消遣方面显著优于喉全切除术组(P<0.01),在外貌和呼吸道症状改善明显优于后者(P<0.05);喉全切除术组在疼痛方面优于喉部分切除术组(P<0.01),悲观失望及抑郁、焦虑情绪较喉部分切除组明显(P<0.05)。结论在不降低生存率的前提下,尽量选择提高生存质量的喉部分切除术。

Objective To investigate the quality of life of the patients after laryngectomy. Methods A survey was conducted among 93 patients with partial laryngectomy and 42 patients with total laryngectomy. The survey included three questionnaires ： （ 1 ） university of Washington-QOL scale ; （ 2 ） QLQ-H＆N37 Scale of European Organization for Re- search and Treatment of Cancer ; （ 3 ） Hospital anxiety and depression scale. Results The 3-year survival rate was 73.33%. The survival rate of patients with Stage I and Ⅱ was higher than that of Stage Ⅲ and IV,so did the quality of life（P 〈0.01 ）. The composite QOL scores of the partial laryngectomy group were higher than those of the total laryngec- tomy group （P 〈 0.01 ）. The partial laryngectomy group was better than the other group in speech, leisure（ P 〈 0.01 ）, appearance and respiratory symptoms （P 〈 0.05 ）. But the group of total laryngectomy was superior to the group of partial laryngectomy in pain（P 〈0.01 ）. The depression,anxiety of the total laryngectomy group was more positive than those of the other group （P 〈 0.05 ）. Conclusions Partial laryngectomy was superior to total laryngectomy in the overall quality of life. Provided that the survival rate couldn＇ t be reduced, partial laryngectomy should be considered firstly. （Chin J Ophthalmol and Otorhinolaryngo1,2010 ,10 ：232-233 ）