中晚期肝癌免疫治疗患者生活质量现状的调查研究

Investigation on the status quo of the quality of life in patients with intermediate and advanced liver cancer treated by immunotherapy

目的分析中晚期肝癌免疫治疗患者生活质量现状及影响因素,为改善中晚期肝癌免疫治疗患者生活质量提供依据。方法选取2022年1月至2023年7月在广西医科大学附属肿瘤医院接受免疫治疗的211例中晚期肝癌患者为研究对象。采用一般资料调查表、医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)、肝胆肿瘤治疗功能评定量表(functional assessment of cancer therapy-hepatobiliary questionnaire,FACT-Hep)进行横断面调查。采用多重线性回归分析生活质量的影响因素。结果中晚期肝癌免疫治疗患者的生活质量总分为(130.04±15.28)分。多重线性回归分析结果显示,HADS-D>7分(β=-10.257,95%CI:-14.862~-5.653)、有既往肝切除手术(β=-8.484,95%CI:-12.765~-4.203)是总生活质量较差的影响因素;HADS-A>7分(β=-2.273,95%CI:-3.866~-0.681)、有既往肝切除手术(β=-2.500,95%CI:-3.825~-1.174)是身体状况维度得分较差的影响因素,文化程度为初中(β=2.574,95%CI:0.862~4.286)、TACE/HAIC(β=1.746,95%CI:0.010~3.482)是身体状况维度得分较好的影响因素;家庭月收入在4000~5999元(β=-2.357,95%CI:-4.429~-0.284)、HADS-D>7分(β=-1.182,95%CI:-1.992~-0.372)是社会/家庭状况维度得分较差的影响因素;HADS-D>7分(β=-3.422,95%CI:-4.276~-2.568)是心理状况维度得分较差的影响因素,肿瘤数目为多发(β=1.053,95%CI:0.131~1.975)是心理状况维度得分较好的影响因素;HADS-D>7分(β=-2.483,95%CI:-3.526~-1.440)是功能状况维度得分较差的影响因素;有既往肝切除手术(β=-4.255,95%CI:-6.560~-1.951)是肝胆特异性状况维度得分较差的影响因素,TACE/HAIC(β=3.555,95%CI:0.590~6.520)是肝胆特异性状况维度得分较好的影响因素。肝胆特异性状况维度得分较差的影响因素。结论中晚期肝癌免疫治疗患者总体健康状况不佳,应重视文化程度低、家庭月收入少、联合治疗、疾病及心理负担重的患者,制定和实施有效的个体化方案以改善其生活质量。

Objective To analyze the status quo and influencing factors of the quality of life in patients with intermediate and advanced liver cancer treated by immunotherapy,and to provide evidence for improving quality of life in patients with intermediate and advanced liver cancer treated by immunotherapy.Methods A total of 211 patients with intermediate and advanced liver cancer who received immunotherapy in the Guangxi Medical University Cancer Hospital from January 2022 to July 2023 were selected as the study objects.A cross-sectional investigation was conducted with general data questionnaire,hospital anxiety and depression scale(HADS),functional assessment of cancer therapy-hepatobiliary questionnaire(FACT-Hep).Multiple linear regression was used to analyze the influencing factors of quality of life.Results The total score of quality of life in patients with intermediate and advanced liver cancer treated by immunotherapy was(130.04±15.28).Multiple linear regression analysis showed that HADS-D>7 score(β=-10.257,95%CI:-14.862,-5.653)and previous hepatectomy(β=-8.484,95%CI:-12.765,-4.203)were the influencing factors of poor total quality of life.HADS-A>7 score(β=-2.273,95%CI:-3.866,-0.681),previous hepatectomy(β=-2.500,95%CI:-3.825,-1.174)were the influencing factors of the poor score of physical condition;and secondary school education level(β=2.574,95%CI:0.862,4.286),TACE/HAIC(β=1.746,95%CI:0.010,3.482)were the influencing factors of the better score of physical condition.Monthly family income was 4,000-5,999 yuan(β=-2.357,95%CI:-4.429,-0.284),HADS-D>7 score(β=-1.182,95%CI:-1.992,-0.372)were the influencing factor of poor score of social/family status.HADS-D>7 score(β=-3.422,95%CI:-4.276,-2.568)was the influencing factor of the poor score of psychological status;and multiple tumors score(β=1.053,95%CI:0.131,1.975)was the influencing factor of the better score of psychological status.HADS-D>7 score(β=-2.483,95%CI:-3.526,-1.440)was the influencing factor of the poor score of functional status.Previous hepatectomy(β=-4.255,95%CI:-6.560,-1.951)was the influencing factor of the poor score of hepatobiliary specific status dimension;and TACE/HAIC(β=3.555,95%CI:0.590,6.520)was the influencing factor of the better score of hepatobiliary specific status dimension.Conclusions The overall health status of patients with intermediate and advanced liver cancer treated by immunotherapy is poor.It is necessary to pay attention to patients with low education level,low monthly family income,combined therapy,and heavy disease and psychological burden,and effective individualized programs should be formulated and implemented to improve the quality of life.