基于评价指标的乳腺癌治疗质量影响因素分析

Analysis of influence factors of breast cancer treatment quality based on evaluation indicators

目的基于乳腺癌治疗质量评价指标,分析影响乳腺癌治疗质量的因素,为改善乳腺癌治疗质量提供依据。方法收集乳腺癌患者病案资料,选择乳腺癌治疗质量评价指标,利用患者平均法计算治疗质量综合得分;根据得分中位数将患者划分为高低质量组,利用logistic回归分析乳腺癌治疗质量的影响因素。结果收集乳腺癌患者3006例,患者得分的中位数为0.7692,高、低质量组患者人数分别为1436例、1570例。单因素分析显示,医保状况、居住地、工作、肿瘤多病灶、组织学分级、病理分期及手术方式的治疗质量得分差异具有统计学意义(P<0.05)。多因素分析显示,工作、既往史、肿瘤多病灶、病理分期、手术方式是乳腺癌治疗质量的影响因素。结论有工作、无既往史、肿瘤多病灶、病理分期低、进行保乳手术的患者更易获得较高的治疗质量。在治疗乳腺癌患者时,关注和改变有既往病史的乳腺癌患者的治疗方式,对病理分期高的患者进行心理疏导,建议符合保乳条件的患者进行保乳手术,以提高乳腺癌治疗质量。

Objective To provide the evidence on improving the treatment quality of breast cancer,and to analyze the corresponding factors based on the treatment quality evaluation indicators.Methods Medical records of breast cancer patients were collected and the treatment quality score were calculated by patient average method.According to the median of the score,the patients were divided into high-quality and low-quality groups,and we analyzed the influencing factors of the treatment quality of breast cancer by logistic regression.Results Three thousand and six patients with breast cancer were collected and the median of score was 0.7692.The patients in high-quality and low-quality groups were 1436 and 1570 respectively.Medical insurance,residence,work status,multifocal tumor,histological grade,pathological stage and operation mode were showed statistical significance between two groups(P<0.05)by univariate analysis.Work status,previous history,multifocal tumor,pathological stage and operation mode were showed statistically significance of breast cancer treatment quality by multivariate analysis.Conclusion Patients with work,no previous history,multifocal tumor,low pathological stage and receiving breast conservation surgery are more likely to obtain higher treatment quality.In order to improve the quality,we should pay more attention to the therapy method of patients who have previous history,provide psychological counseling for patients with high pathological stage,and suggest patients who meet the conditions of breast conservation to receive breast conservation surgery.