电视胸腔镜肺癌切除术后患者生活质量及其影响因素研究

Quality of life and influencing factors in lung cancer patients after video-assisted thoracic surgery

目的分析电视胸腔镜手术(video-assisted thoracic surgery,VATS)肺癌切除术后患者围手术期生活质量,并探讨其相关影响因素。方法连续收集2020年7月—2021年8月在四川大学华西医院胸外科行VATS肺癌切除术患者的临床资料。利用癌症患者生活质量核心量表(QLQ-C30)和癌症特异量表(QLQ-LC13)调查患者术后第30 d的生活质量,并分析其影响因素。结果共纳入193例患者,其中男73例,平均年龄(59.44±11.40)岁,女120例,平均年龄(53.73±11.15)岁。VATS肺癌切除术后第30 d患者整体生活质量评分为(69.09±20.21)分。单因素分析和Pearson相关性分析显示,年龄、职业、麻醉时间、术后并发症、术后抗生素使用时间、术后住院时间、失眠、经济压力、咯血、胸痛、吞咽困难、手臂或肩膀疼痛与术后生活质量有关(P≤0.05)。多元回归分析结果显示,麻醉时间、经济压力、失眠和胸痛对患者术后30 d整体生活质量有显著影响(P≤0.05)。结论麻醉时间、经济压力、失眠和胸痛是微创肺癌切除术后30 d患者生活质量的独立影响因素。

Objective To investigate the short-term quality of life in patients after single-direction video-assisted thoracic surgery(VATS)for lung cancer,and explore the related influencing factors.Methods Patients who underwent single-direction VATS for lung cancer in the Department of Thoracic Surgery,West China Hospital,Sichuan University from July 2020 to August 2021 were continuously selected.The QLQ-C30 and QLQ-LC13 were used to evaluate the quality of life of the patients after the surgery,and the influencing factors were analyzed.Results A total of 193 patients were collected.There were 73 males aged 59.44±11.40 years,and 120 females aged 53.73±11.15 years.The QLQ-C30 score of the patients after single-direction VATS for lung cancer was 69.09±20.21 points.Univariate analysis and Pearson correlation analysis showed that age,occupation,anesthesia time,postoperative complications,postoperative antibiotic use time,postoperative hospital stay,insomnia,economic stress,hemoptysis,chest pain,dysphagia,arm or shoulder pain were associated with the quality of life(P≤0.05).The results of multiple regression analysis showed that anesthesia time,economic pressure,insomnia and chest pain had a significant impact on the overall quality of life 30 days after the surgery(P≤0.05).Conclusion The anesthesia time,economic pressure,insomnia and chest pain are independent influencing factors for the quality of life after the VATS lung cancer surgery.