口腔颌面部恶性肿瘤患者术后生存质量影响因素分析

Influencing factors for postoperative quality of life in patients with oral and maxillofacial malignancies

目的:探讨口腔颌面部恶性肿瘤患者术后生存质量的影响因素。方法:选取国内某三甲口腔专科医院2016年1月至2018年3月接受手术治疗的90名口腔颌面部恶性肿瘤患者为研究对象,通过现场访谈、问卷调查及数据测量等方式采集人口学、社会心理学及医疗护理方面共29个因素,利用头颈部肿瘤患者生活质量测定量表第4版生活质量问卷评估患者的术后生存质量。再通过单因素及多因素分析,确定影响术后生存质量的独立影响因素。结果:单因素和多因素分析结果显示,有无下颌骨节段切除(OR=50.897,P=0.035,95%CI=1.319~1 964.684)、中文版安德森吞咽困难量表评分(OR=1.260,P=0.002,95%CI=1.086~1.462)、社会支持好(OR=677.074,P=0.045,95%CI=1.166~381 787.087)、微型营养评估记录表评分(OR=28.788,P=0.041,95%CI=1.151~719.778)是口腔颌面部恶性肿瘤患者术后生存质量的独立影响因素。结论:保留口腔颌面部恶性肿瘤患者下颌骨连续性、重建吞咽功能、改善营养状况以及社会支持是提高术后生存质量的有效途径。

Objective:To investigate the influencing factors for postoperative quality of life(QOL)in patients with oral and maxillofacial malignancies(OMMs).Methods:A total of 90 patients with oral and maxillofacial malignancies(OMMs)who underwent surgical treatment in a grade A tertiary stomatological hospital in China from January 2016 to March 2018 were selected as subjects.Twentynine factors of demography,social psychology,and medical care were collected by on-site interviews,questionnaires,and data measurements.The postoperative QOL of patients was evaluated using Functional Assessment of Cancer Therapy-Head and Neck-V4(FACT-H&N(V4))Independent factors for postoperative QOL were analyzed by univariate and multivariate analyses.Results:The univariate and multivariate analyses showed that segmental resection of lower jaw bone(OR=50.897,95%CI=1.319 to 1 964.684,P=0.035),M.D.Anderson Dysphagia Inventory(MDADI)score(OR=1.260,95%CI=1.086 to 1.462,P=0.002),good social support(OR=677.074,95%CI=1.166 to 381 787.087,P=0.045)and mini nutritional assessment(MNA)score(OR=28.788,95%CI=1.151 to719.778,P=0.041)were independent influencing factors for the QOL of patients with OMMs.Conclusion:It is an effective way to improve the postoperative QOL of patients with OMMs by retaining the continuity of lower jaw bone,reconstructing swallowing function and improving nutritional status and social support.