肺癌不同手术方式对女性患者生活质量影响的调查分析

Investigation and analysis about influence of different surgical strategies with lung cancer on quality of life in female patients

目的：探讨一侧全肺切除与肺叶切除两种手术方式对女性患者生活质量的影响。方法回顾性分析2010年10月～2013年10月行一侧全肺切除或肺叶切除、有完整随访记录的133例女性肺癌患者的临床资料,其中54例行一侧全肺切除（全肺切除组）,79例行肺叶切除（肺叶切除组）。术后3个月,参照EORTC QLQ-C30量表,逐条对患者进行问卷调查,从躯体功能、物质生活、心理功能、认知功能、社会功能、总体健康状况等方面评估患者的生活质量,并比较两组普通症状参数评分及相关症状发生率。结果全肺切除组的躯体功能、心理功能、社会功能、总体健康状况评分均低于肺叶切除组,差异有统计学意义（P＜0.05）；全肺切除组的乏力、心慌气短及呼吸困难评分明显高于肺叶切除组,差异有统计学意义（P＜0.05）；两组的憋气、膈肌升高及气管偏移发生率比较差异有统计学意义（P＜0.05）。结论一侧全肺切除的女性肺癌患者术后早期生活质量明显降低,生理压力、心理压力及临床症状可降低术后生活质量。

Objective To explore the influence of two surgical strategies about pneumonectomy and pulmonary lobectomy on quality of life in female patients. Methods The clinical data of 133 female patients with lung cancer under went pneumonectomy or pulmonary lobectomy and with total follow-up record from October 2010 to October 2013 were retrospectively analyzed.The pneumonectomy was used in pneumonectomy group （54 patients）,pulmonary lobectomy was applied in pulmonary lobectomy group （79 patients）.After surgery of 3 months,with reference to the EORTC QLQ-C30,questionaire survey was conducted to evaluate patients’ quality of life from the following aspects：physical functioning,material life,emotional function,cognitive function,social function,the overall health status.The common symptom parameters score,the incidence rate of associated symptom in two groups was compared respectively. Results The score of physical functioning,emotional function,social function,the overall health status in pneumonectomy group was lower than that in pulmonary lobectomy group respectively,with statistical difference （P〈0.05）.The score of hypodynamia,palpitation and shortness of breath,breathing difficulty in pneumonectomy group was significantly higher than that in pulmonary lobectomy group respectively,with statistical difference （P〈0.05）.The incidence rate of suffocation,diaphragmatic elevention and tracheal deviation in two groups was compared respectively,with statistical difference （P〈0.05）. Conclusion Postoperative quality of life of pneumonectomy in female patients with lung cancer is obviously decreased,physiological stress,psychological and clinical symptom can reduce their postoperative quality of life.