基于倾向值匹配方法探索肥胖对食管癌术后生活质量的影响研究

Effects of overweight on quality of life for postoperative patients with esophageal cancer based on propensity score matched method

目的探讨肥胖对食管癌患者术后生活质量(Quality of life,QOL)的影响。方法选择2016年4月-2017年1月在山东省某三级甲等医院胸外科接受食管癌切除的患者343例,根据体质量指数分为肥胖组234例和正常体质量组109例,采用倾向值匹配方法得到肥胖组和正常体质量组各93例,比较两组患者生活质量的差异。结果两组患者的总体生活质量差异无统计学意义(P>0.05),但肥胖组与正常体质量组的疲乏得分分别为(38.95±15.07)分和(33.69±15.75)分、食欲减退得分分别为(31.90±26.88)分和(24.37±24.64)分、饮食失调得分分别为(27.33±14.35)分和(23.18±13.69)分,肥胖组高于正常体质量组,差异有统计学意义(P<0.05)。结论肥胖不会影响患者术后整体生活质量,但是会加重食管癌患者的术后疲乏感,影响营养状况,导致营养不良发生的风险增加。所以合理的术前减重和术后营养支持对肥胖的食管癌患者来说极为重要。

Objective To study the effects of overweight on quality of life(QOL)and complications for postoperative patients with esophageal cancer.Methods 343 patients were divided into Obese group(O group)and normal weight group(N group)according to body mass index(BMI).There were 93 cases in each of O group and N group after patients were matched using the propensity score matched(PSM)method.The quality of life of 6 months after operation and complications were evaluated to explore the effect of obesity.Results There was no difference on quality of life,and complications rates between O group and N group(P>0.05).However,patients in O group was scored significantly higher in fatigue(38.95±15.07 vs.33.69±15.75),appetite loss(31.90±26.88 vs.24.37±24.64)and eating disorders(27.33±14.35 vs.23.18±13.69)compared with N group(P<0.05).Conclusion Obesity can affect the postoperative nutritional status of patients with esophageal cancer and increase the risk of malnutrition.Reasonable preoperative weight loss strategy and postoperative nutrition support care are necessary for obese patients with esophageal cancer.However,obesity does not increase the incidence of complications or global quality of life.