肝癌术后重症老年患者术后3个月随访状态调查

Status of elderly critically ill patients at three months follow-up after liver cancer surgery

目的探讨肝癌术后重症老年患者近期生存质量并分析其影响因素。方法回顾性分析2020年2月至2022年3月新疆医科大学附属肿瘤医院收治的152例肝癌术后入住重症监护室的重症老年患者的临床资料。术前及术后3个月使用老年营养风险指数(GNRI)评估患者营养风险,术后3个月使用肝癌患者生命质量测定量表(QOL-LCV2.0)评估患者近期生存质量。根据术后3个月患者生存质量测定结果将患者分为生存质量良好组(78例)与生存质量不良组(74例)。采用SPSS 24.0统计软件进行数据分析。根据数据类型,分别采用χ2检验或t检验进行组间比较。采用logistic回归分析评估肝癌术后重症老年患者近期生存质量不良的影响因素。结果肝癌术后重症老年患者术后3个月QOL-LCV2.0总得分为(124.89±9.22)分。Logistic回归分析显示,年龄≥70岁(OR=1.929,95%CI 1.011~4.290;P<0.05)、术前GNRI≤98(OR=3.593,95%CI 2.252~5.734;P<0.05)及术后并发症(OR=2.550,95%CI 1.411~4.606;P<0.05)均为肝癌术后重症老年患者近期生存质量不良的危险因素。结论肝癌术后重症老年患者近期生存质量值得关注,年龄、营养风险及术后并发症是影响患者近期生存质量的重要因素。

Objective To investigate the short-term quality of life in the elderly critically ill patients after liver cancer surgery and to analyze its influencing factors.Methods A retrospective analysis was made of the clinical data of 152 elderly critically ill patients admitted to intensive care unit after liver cancer surgery in the Affiliated Cancer Hospital of Xinjiang Medical University from February 2020 to March 2022.Before surgery and at three months after surgery,geriatric nutritional risk index(GNRI)was used to assess the nutritional risk of patients.At three months after surgery,quality of life with liver cancer(QOL-LCV2.0)was used to evaluate the short-term quality of life.Patients were classified into the good life-quality group(n=78)and poor life-quality group(n=74)according to the quality of life measured at three months after surgery.SPSS 24.0 was used for data analysis.According to the data type,Chi-square test or t test was used to compare the enumeration data between groups.Logistic regression analysis was used to evaluate the influencing factors of poor short-term quality of life in the elderly critically ill patients after liver cancer surgery.Results At three months after surgery,the total score on QOL-LCV2.0 of the elderly critically ill patients after liver cancer surgery was(124.89±9.22)points.Logistic regression analysis showed that age≥70 years(OR=1.929,95%CI 1.011-4.290;P<0.05),preoperative GNRI≤98(OR=3.593,95%CI 2.252-5.734;P<0.05),and postoperative complications(OR=2.550,95%CI 1.411-4.606;P<0.05)were risk factors for poor short-term quality of life in the elderly critically ill patients after liver cancer surgery.Conclusion The short-term quality of life in the elderly critically ill patients after liver cancer surgery is worthy of attention.Age,nutritional risk and postoperative complications are important factors affecting their short-term quality of life.