BCLC分期B期及以上的中晚期肝癌患者姑息治疗照护需求水平及影响因素分析

Analysis of level of care needs and influencing factors for palliative care in patients with BCLC stage B and above advanced liver cancer

目的探讨巴塞罗那临床肝癌(BCLC)分期B期及以上的中晚期肝癌患者姑息治疗照护需求水平及其影响因素。方法选取2018年1月至2020年10月该院接诊的BCLC分期在B期及以上的156例中晚期肝癌患者进行研究。以问卷调查法收集患者一般资料、卡氏功能评分、焦虑、抑郁情况,采用姑息照护结局量表(POS)评估患者姑息照护需求水平,比较不同姑息照护需求情况患者POS得分,并行多元线性回归分析。结果本次调查共发放156份问卷,回收有效问卷151份,回收有效率为96.79%。有效病例中POS得分为4~29分,平均(15.02±4.75)分。不同年龄、BCLC分期、病程、肝功能失代偿情况、家庭月收入、卡氏功能评分、焦虑、抑郁、疼痛视觉模拟量表(VAS)评分的中晚期肝癌患者POS得分比较,差异有统计学意义(P<0.05)。进入多元线性回归方程的变量有BCLC分期、肝功能失代偿情况、焦虑、抑郁、VAS评分(P<0.05),可解释总变异的62.1%。结论中晚期肝癌患者姑息治疗照护需求受BCLC分期等因素的影响。

Objective To investigate the level of palliative care needs and its influencing factors in Barcelona clinic liver cancer(BCLC) stage B and above.Methods A total of 156 patients with advanced liver cancer in BCLC stage B and above admitted in this hospital from January 2018 to October 2020 were selected for the study.The general information, Karnofsky functional score, anxiety and depression of the patients were collected by the questionnaire survey method.The palliative care outcome scale(POS) was used to evaluate the level of patients’ palliative care needs.The POS scores were compared among the patients with different palliative care needs, and multiple linear regression was conducted.Results A total of 156 questionnaires were distributed in this survey, and 151 valid questionnaires were collected, with a recovery effective rate of 96.79%.Among the valid cases, the POS score was 4-29 points, with an average of(15.02±4.75) points.There were statistically significant differences in POS scores of the patients with advanced liver cancer in different ages, BCLC stage, course of disease, liver decompensation, family monthly income, Karnofsky function score, and anxiety, depression and pain visual analog scale(VAS) scores(P<0.05).The variables entering into the multiple linear regression equation had the BCLC stage, liver function decompensation, anxiety, depression and VAS score(P<0.05),which could explain 62.1% of the total variation.Conclusion The demand of palliative care for the patients with advanced liver cancer is affected by the factors such as BCLC stage.