肺癌患者远期生活质量及影响因素分析

Analysis on long-term quality of life and its influencing factors in patients with lung cancer

目的探讨肺癌患者远期生活质量的影响因素。方法回顾性分析2010年1月1日至2016年6月30日河北省唐山市第三医院收治的按原发性肺癌诊疗规范,经病理学和/或细胞学和/或临床首次确诊为原发性肺癌患者的相关资料,共74例入选。应用肺癌FACT-L(4.0)中文版生活质量调查表,对74例生存时间≥3年的原发性肺癌患者进行生活质量测评。应用多元回归统计方法,分析其主要影响因素。结果所调查的远期生存肺癌患者均经手术治疗,其生活质量得分(126.62±13.29)分,年龄、参保类别、临床分期对生活质量有显著影响(P<0.05),<50岁组、≥50~60岁组与≥60岁组生活质量评分差异有统计学意义(F=4.579,P=0.013),其中<50岁组生活质量评分(138.18±13.92)分与≥50~<60岁组生活质量评分(137.04±12.82)分比较差异无统计学意义(P>0.05),但均高于≥60岁组(115.28±13.11)分,P均<0.05);居民医保患者生活质量评分(117.92±13.13)分低于职工医保患者(142.69±13.07)分(t=10.849,P=0.002);Ⅰ、Ⅱ期患者生活质量评分差异有统计学意义(F=14.921,P<0.001),Ⅰ、Ⅱ期患者生活质量评分[(140.34±12.88)分、133.31±12.07)分]差异无统计学意义,但均高于Ⅲ期(96.84±13.46)分,P<0.05)。结论早期发现、及时手术、同时不断完善医疗保障制度、降低患者的经济负担,手术后长期生存肺癌患者能保持较高的生活质量。

Objective To explore the influencing factors of the long-term quality of life(QOL).Methods According to the standard of diagnosis of primary lung cancer,a total of 74 patients with primary lung cancer were included in the study,who were first diagnosed by pathology and/or cytology and/or clinic from 1 January 2010 to 30 June 2016 in Tangshan Third Hospital,Heibei Province,and whose data were analyzed retrospectively.The Chinese version of FACT-L(4.0)QOL questionnaire was used to evaluate the QOL in 74 patients with primary lung cancer who survived more than three years.Multivariate regression statistical method was used to analyze the main influencing factors.Results All patients with long-term survival lung cancer were treated by operation,their average QOL score was(126.62±13.29).Age,type of medical insurance and clinical stage had significant influence on QOL(P<0.05).There was no significant difference in the total QOL scores between<50-year-old group(138.18±13.92)and≥50-<60-year-old group(138.18±13.92,137.04±12.82)(all P>0.05),but they were higher than that in≥60-year-old group(115.28±13.11)(all P<0.05).The QOL of residents′medical insurance patients(117.92±13.13)was lower than that of employees′medical insurance patients(142.69±13.07)(t=10.849,P=0.002).The QOL scores of stageⅠandⅡ(140.34±12.88,133.31±12.07)had no significant difference,but which were higher than that of stage III(96.84±13.46)(P<0.05).Conclusion Patients with long-term survival lung cancer after surgery could maintain a better QOL by early detection,timely surgery and constantly improving the medical security system to reduce the financial burden of patients.