中老年妇科恶性肿瘤化疗患者合并症负担及症状群的调查分析

Correlation study of complication burden,symptom clusters and quality of life in middle-aged and elderly patients with gynecological malignant tumor undergoing chemotherapy

目的 调查中老年妇科恶性肿瘤化疗患者的合并症负担、症状群和生活质量,分析其相关性。方法 对新疆某肿瘤专科医院212名接受化疗的妇科恶性肿瘤患者进行症状群和生活质量的调查,查阅病历统计除肿瘤以外其他慢性疾病的数量。采用查尔森合并症指数(CCI)评估合并症负担,并比较高合并症组(≥3分)、低合并症组(<3分)患者症状群严重程度、症状对日常生活的干扰度及生活质量方面的差异,分析影响患者生活质量的相关因素。结果 212名患者的合并症数量为0~6个,CCI评分为(6.27±1.74)分;高血压、糖尿病、贫血是患者常见的慢性病;患者合并症评分与症状群严重程度、症状对日常生活干扰度得分呈正相关,合并症评分与患者生活质量总分及各维度得分呈负相关;高、低合并症组症状群严重程度及生活质量得分差异均有统计学意义(P<0.05);合并症评分、症状严重程度、化疗次数、婚姻状况和家庭人均月收入影响患者生活质量水平。结论 中老年妇科恶性肿瘤化疗患者合并症数量较多,症状群较为严重,生活质量水平不高。高合并症负担对改善患者症状群与生活质量造成一定的阻碍,临床急需加强患者症状群和慢性病的综合管理,从而达到提高患者生活质量的目的。

Objective To investigate the complication burden,symptom clusters and quality of life in middle-aged and elderly patients with gynecological malignant tumor undergoing chemotherapy,and to explore the correlation.Methods A total of 212 patients with gynecological malignant tumor who received chemotherapy in the hospital were investigated in terms of symptom clusters and quality of life.Charleson comorbidities index(CCI) was used to evaluate the burden of comorbidities,and the differences in the severity of symptoms,the interference of symptoms on daily life and quality of life of patients in the high comorbidities clusters(≥3 points) and the low comorbidities clusters(<3 points)were compared,and the related factors that affecting the quality of life of the patients were analyzed.Results The number of complications in 212 patients ranged from 0 to 6 points,and CCI score was(6.27±1.74).Hypertension,diabetes and anemia were common chronic diseases.The comorbidity score was positively correlated with the severity of the symptom clusters and the interference degree of symptom to daily life,while the comorbidity score was negatively correlated with the total score of quality of life and the scores of all dimensions.The scores of the symptom clusters severity and quality of life in high and low comorbidity clusterss were significantly different(P<0.05).Comorbidities score,severity of symptoms,number of chemotherapy,marital status and per capita monthly income of family affected the quality of life of the patients.Conclusion Middle-aged and elderly patients with gynecological malignant tumor undergoing chemotherapy have more comorbidities,more serious symptoms,and lower quality of life.The high burden of comorbidities hinder the improvement of the patients′ symptom clusterss and quality of life.It could be urgent for strengthen the comprehensive management of patients′ symptom clusterss and chronic diseases and to achieve the purpose of improving patients′ quality of life.