甲状腺癌患者术后特异性生活质量的现状及其影响因素分析

Current status of postoperative specific quality of life and its influencing factors analysis for patients with thyroid cancer

目的调查分化型甲状腺癌(differential thyroid cancer,DTC)患者术后的生活质量情况,同时分析其相关影响因素。方法通过术后随访平台和随访管理群对2021年12月1日至2023年10月1日期间在郑州大学第一附属医院进行手术切除的DTC患者进行调查,分别采用汉化版甲状腺癌特异性生命质量问卷(Thyroid Cancer-Specific Quality of Life Questionnaire,THYCA-QoL)和中文版欧洲癌症研究与治疗组织(European Organization for Research and Treatment of Cancer,EORTC)开发的由30个项目组成的生活质量问卷(quality of life questionnaire consisting of 30 items,QLQ-C30)普适性量表评价DTC患者术后的生活质量,其中THYCA-QoL量表平均总得分越高,提示患者临床症状越多即生活质量越差;QLQ-C30总体健康状况评分越高,提示患者生活质量越好。此外,采用多重线性回归分析影响DTC患者术后生活质量得分的风险因素。结果本研究共收集到1076例患者的问卷调查表。1076例患者的QLQ-C30总体健康状况评分为(67±22)分,THYCA-QoL量表总评分为(22±13)分。多重线性回归分析结果发现,术后早期(<6个月)、男性、年龄、术后不终生服药及术后不行碘-131放射治疗对THYCA-QoL量表总评分产生负向影响(P<0.05),而术后早期(<6个月)或后期(≥12个月)、术后不终生服药及术后不行碘-131放射治疗对QLQ-C30总体健康状况评分产生正向影响(P<0.05)。结论本研究采用QLQ-C30结合THYCA-QoL评估DTC患者术后生活质量,不仅评估了患者术后的癌症共性症状,也评估了甲状腺癌特异性症状,了解甲状腺癌患者术后生活质量的影响因素,能够为出院患者提供针对性和支持性的治疗和护理,以改善甲状腺癌患者术后生活质量。

Objective To investigate the quality of life(QoL)of patients with differentiated thyroid cancer(DTC)after surgery and analyze its relevant influencing factors.Methods The patients with DTC who underwent surgical resection in the First Affiliated Hospital of Zhengzhou University from December 1,2021 to October 1,2023 were investigated through the postoperative follow-up platform and follow-up management group.The postoperative QoL of DTC patients were evaluate using the Chinese version of the Thyroid Cancer Specific Quality of Life Questionnaire(THYCA-QoL)specific scale and the Chinese version of the European Organization for Research and Treatment of Cancer(EORTC)developed a quality of life questionnaire consisting of 30 items(QLQ-C30).The higher overall average score of THYCA-QoL scale,the more clinical symptoms of patients,namely the negative QoL.The higher the EORTC QLQ-C30 overall health status score,the better QoL.In addition,multiple linear regression was used to explore the risk factors affecting the postoperative specific QoL score of DTC patients.Results A total of 1076 patients’questionnaires were collected.The EORTC QLQ-C30 overall health status score of 1076 patients was 67±22 and the THYCA-QoL overall score was 22±13.The results of multivariate linear regression analysis showed that the early postoperative period(<6 months),male,age,without postoperative lifetime medication and without postoperative iodine-131 radiotherapy had negative effects on the overall score of THYCA-QoL scale(P<0.05),meanwhile the early postoperative period(<6 months)or later(≥12 months),without postoperative lifetime medication and without postoperative iodine-131 radiotherapy had positive effects on the overall health status score of EORTC QLQ-C30(P<0.05).Conclusions EORTC QLQ-C30 combined with THYCA-QoL can evaluate not only the common symptoms of cancer,but also the specific symptoms of thyroid cancer after surgery.And understanding the factors affecting the QoL of patients with thyroid cancer after surgery could provide targeted and supportive treatment and nursing for discharged patients to improve the QoL of patients with thyroid cancer after surgery.