下咽鳞状细胞癌保留喉功能手术与全喉切除术术后患者生活质量比较

Comparison of quality of life of hypopharyngeal squamous cell carcinoma patients after laryngeal preservation surgery and total laryngectomy

目的评估并比较下咽鱗状细胞癌患者行保留喉功能手术与全喉切除术后的生活质量.方法借鉴欧洲癌症研究与治疗组织生命质量量表的核心量表EOKTC QLQ-C30和头颈专用量表EORTCQLQ-H&N35的部分项目,设计患者生活质量量表。对42例行保留喉功能手术(保喉术组)、38例行全喉切除术(全喉切除术组)的下咽鱗状细胞癌患者进行生活质量调查,并随访其生存情况,结果保喉术组患者的躯体功能评分、心理功能评分和社会功能评分分别为(92.46±15.71)分、(80.56±22.67)分和(90.08±19.50)分,均高于全喉切除术组[分别为(79.39±32.75)分、(68.42±25.05)分和(61.84±29.55)分,均P<0.05],两组患者的经济影响评分差异无统计学意义(P>0.05)。按照中位术后时间(70个月)分层分析显示,术后时间<70个月和术后时间英70个月,保喉术组患者的社会功能评分(包括社会支持与社交、家庭相处评分)分别为(89.04±25.47)分和(90.94±13.28)分,均高于全喉切除术组[分别为(65.48±29.14)分和(57.35±30.32)分,均P<0.01]。结论行保留喉功能手术比全喉切除术,下咽鳞状细胞癌患者术后躯体功能、心理功能和社会功能更优.应在确保患者远期生存的前提下,尽量保留喉功能,以提高患者的生活质量。

Objective To evaluate and compare the quality of life(QOL)in patients withhypopharyngeal squamous cell carcinoma after laryngeal preservation surgery and total laryngectomy.Methods We selected parts of the European Organization for Research and Treatment of Cancer Quality ofLife Questionnaire C30 and the Head and Neck Module(EORTC QLQ-C30 and EORTC QLQ-H&N35)anddesigned the QOL questionnaire。We investigated 42 patients with hypopharyngeal squamous cell carcinomaunderwent laryngeal preservation surgery and 38 patients underwent total laryngectomy by QOL questionnaireand followed up their survival.Results The somatic function dimension,psychological function dimension,and social function dimension of patients underwent laryngeal preservation surgery were(92.46±15.71),(80.56±22.67)and(90.08±19.50),respectively,which were higher than(79.39±32.75),(68.42±25.05)and(61.84±29.55)of the total laryngectomy group(P<0.05),while the economic dimension wasnot significantly different between the two groups(P>0.05).The social function dimension(including socialsupport and socialization,family relationship)of laryngeal preservation surgery group were(89.04+25.47)for postoperative time<70 months and(90.94±13.28)for postoperative time≥70 months,which were higherthan(65.48±29.14)and(57.35±30.32)of the total laryngeclomy group(P<0.01).Conclusions Thesomatic function dimension,psychological function and social function of patients with hypopharyngealsquamous cell carcinoma underwent laryngeal preservation surgery obtain a better QOL than patientsunderwent total laryngectomy.Therefore,we should improve the laryngeal function and QOL of patients under the premise of ensuring the survival rate.