大理白族地区消化道恶性肿瘤患者术后生存质量的影响因素及其干预措施

Influencing factors and intervention measures of postoperative quality of life in patients with digestive tract malignant tumors in Dali Bai nationality area

目的分析大理白族地区消化道恶性肿瘤患者术后生存质量的影响因素,并采取针对性干预措施。方法收集大理州2021年9月至2023年9月收治的123例经过手术治疗的消化道恶性肿瘤患者的临床资料。根据Karnofsky功能状态(KPS)评分将患者分为生存质量低下组(57例)和生存质量良好组(66例)。对患者进行问卷调查,内容包括汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、治疗方式、性别、年龄、民族、临床分期、严重术后并发症及严重化疗反应;采用多因素Logistic回归分析影响消化道恶性肿瘤患者术后生存质量的因素。结果生存质量良好组的HAMA、HAMD评分低于生存质量低下组(P<0.05);两组的治疗方式、民族、临床分期、严重术后并发症、严重化疗反应占比比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,HAMD评分是影响消化道恶性肿瘤患者术后生存质量的独立危险因素(P<0.05)。结论针对抑郁这一威胁消化道恶性肿瘤患者术后生存质量的危险因素,可以及时通过心理干预等手段进行预防,改善患者生存质量。

Objective To analyze the influencing factors of postoperative quality of life in patients with digestive tract malignant tumors in Dali Bai nationality area,and to take targeted intervention measures.Methods The clinical data of 123 patients with digestive tract malignant tumors who underwent surgical treatment in Dali prefecture from September 2021 to September 2023 were collected.According to Karnofsky Performance Status(KPS)score,the patients were divided into low quality of life group(57 cases)and good quality of life group(66 cases).A questionnaire survey was conducted on the patients,including Hamilton Anxiety Scale(HAMA)score,Hamilton Depression Scale(HAMD)score,treatment method,gender,age,nationality,clinical stage,severe postoperative complications and severe chemotherapy reaction.Multivariate Logistic regression analysis was used to analyze the factors affecting the postoperative quality of life of patients with digestive tract malignant tumors.Results The HAMA and HAMD scores of the good quality of life group were lower than those of the low quality of life group(P<0.05);there were significant differences between the two groups in proportions of treatment method,nationality,clinical stage,severe postoperative complications and severe chemotherapy reaction(P<0.05).Multivariate Logistic regression analysis showed that HAMD score was an independent risk factor for postoperative quality of life in patients with digestive tract malignant tumors(P<0.05).Conclusion In view of depression,a risk factor that threatens the postoperative quality of life in patients with digestive tract malignant tumors,it can be prevented in time by means of psychological intervention to improve the quality of life of patients.