贲门腺癌切除术后远期生存质量观察

A Study on Quality of Life in Long-term Survivors Following Surgery for Cardiac Cancer

[目的]探讨贲门腺癌切除术后远期生存患者的生存质量情况。[方法]对96例术后生存超过5年的贲门癌切除术后患者,通过门诊随访、信访以及电话访问,调查患者术后的一般身体状况、消化功能,行化验检查,并与术前或出院时状况进行比较;应用SF-36生存质量量表观察术后患者的生存质量评分,同时对正常体检人群进行调查作为对照组进行比较。并通过多变量方差分析其影响因素。[结果]切除术后患者的吞咽功能有了明显的好转,病人PS评分0～l级83.3%、KPS评分>90者93.6%,能参加劳动和工作的有61.5%。术后曾有腹泻者30.8%,有胃食管反流症状者64.7%。量表观测表明术后躯体功能比正常人群下降,生命力也受到影响,然而,心理健康却得到了改善(P<0.05),其他健康状况,躯体角色、情绪角色、社会功能、身体疼痛5个方面无明显差异(P>0.05)。性别、年龄、职业、文化程度及术后消化功能对生存质量有不同程度的影响(P<0.05)。白细胞、红细胞、血红蛋白、白蛋白实验检查结果术前、术后比较无明显差异(P>0.05)。[结论]贲门癌切除术后远期总的生存质量较为满意,手术治疗有利于生存质量的提高。

To study the quality of life(QOL) in long-term survivors following surgery for cardiac cancer.The general status,digestive function,and laboratory data in 96 patients with cardiac cancer undergoing gastrectomy were investigated and compared with those before operation or on the time of discharge by telephone or questionary.The scores of QOL for the patients following operation were estimated by the Medical Outcomes Study 36-Item Short-Form Health Survey,and compared with that of control group at the same time.The affected factors were analyzed by multivariate variance analysis.The swallowing function was improved obviously in postoperative patients.The patients with 0～1 PS grade accounted for 83.3%;KPS scored more than 90 points,93.6%,and patients able to daily work,61.5%.The patients had postoperative diarrhea in 30.8%,symptoms of gastroesophageal reflux in 64.7%.The scores recorded according to the SF-36 that the physical functioning and overall status of the postoperative patients were declined compared to those of control group.However,the mental health scores were improved(P<0.05).The other 5 scores were not affected apparently.Gender,age,occupation,education,digestive function after operation had certain influence on QOL. Hemoglobin,albumin, erythrocyte count, and leucocyte count had no significant difference pre-and post-operation.[Conclusions]The long-term QOL in patients with cardiac cancer following surgery is satisfactory.Surgical resection is beneficial to improve patient's quality of life.