无病生存白血病儿童生存质量调查和影响因素研究

Quality of life of long-term survivors with leukemia

目的调查无病生存白血病儿童生存质量及其相关因素。方法选择无病生存白血病儿童113例为观察组，选同期门诊体检健康儿童113例为对照组。采用儿童生存质量测定表体系对2组儿童的生存质量进行调查，并采用多因素非条件性Logistic回归模式分析影响无病生存白血病儿童生存质量的相关因素。结果无病生存白血病儿童在生理、情感、社交以及学校功能上均低于正常儿童，差异有统计学意义[生理功能：（69±13）分比（86-1-9）分，情感功能：（79±10）分比（86士7）分，社交功能：（76±10）分比（89±8）分，学校功能：（77±10）分比（88±8）分，均P〈0．01]；多因素分析显示经过放射治疗[比值比（OR）=3．456，95％置信区间（CI）：0．853—9．234]、有中度以上疼痛（OR=3．212，95％CI：0．345—8．234）、总住院时间〉3个月（OR=1．234，95％CI：0．453—10．232）、疾病反复发作（OR=1．234，95％CI：0．456—11．232）是影响白血病儿童生存质量的危险因素。结论无病生存白血病儿童生存质量较差，其中放射治疗、中度以上疼痛、住院时间、反复发作是导致患儿生存质量下降的相关因素。

Objective To Research the quality of life of long-term survivors with leukemia and related factors. Methods All 113 children with leukemia who survived with disease-free were included in observation group; 113 cases of healthy children at the same term were included in control group. By using multi factors non conditional Logistic regression analysis, the related factors influencing life quality of children with leukemia were analyzed. Results The children＇s physiological function, emotional function, social function and the function of school in observation group were lower than those in the control group [ physiological functions： （69 ±13）scores vs （86 ±9） scores, emotional function： （79 ± 10） scores vs （86 ±7） scores, social function： （76 ± 10） scores vs （ 89 ± 8 ） scores, school functions ： （77 ± 10） scores vs （ 88 ± 8 ） scores, P 〈 0.01 ], multivariate analysis showed that after radiotherapy（ OR = 3. 456, 95% CI： 0. 853-9. 234）, more than moderate pain （ OR = 3. 212, 95% CI： 0. 345-8. 234）, a total hospital stay of 〉 3 months （ OR = 1. 234, 95% CI： 0. 453-10. 232）, disease recurrent episodes（OR= 1. 234, 95% CI： 0. 456-11. 232） were the influence factors of quality of life in children with leukemia. Conclusion Long-term survivors with leukemia have poor quality of life. Radiotherapy, pain, hospitalization time, repeated episodes are the associated factors with decreasing quality of life.