食管癌切除不同消化道重建方式术后患者生命质量对比分析  

Comparison of long-term health-related quality of life in patients with different methods of reconstruction after oncologic esophagectomy

作　　者：李林峻[1] 吴庆琛[1] 张诚[1] 张敏[1] 李强[1] 蒋迎九[1] 陈丹[1] 

机构地区：[1]重庆医科大学附属第一医院胸外科,400016

出　　处：《中华医学杂志》2013年第35期2790-2793,共4页National Medical Journal of China

基　　金：重庆市卫生局基金重点项目（20121015）

摘　　要：目的比较管状胃与全胃代食管的食管癌切除对患者术后生活质量的影响。方法收集重庆医科大学附属第一医院胸外科2007至2008年间收治的104例已行食管癌切除术患者为研究对象，以问卷调查的方式比较两组患者分别在术后3周、6个月、1、2、3年时的生活质量；问卷调查表设计和制定均参照了欧洲癌症研究与治疗组织（EORTC）生活质量调查QLQ—c30量表及QLQ—OES18食管癌专用量表。结果管状胃组患者在术后6个月和1年的生活质量显著优于全胃组（均P〈0．05）；术后3周、术后2、3年时两组患者的生活质量差异无统计学意义。量表25个指标中，反酸选项术后3周、6个月、1年时得分结果均为管状胃组优于全胃组（P〈0．05），在术后第2、3年时两组之间差异无统计学意义；术后第2、3年时管状胃组中恶心一项得分显著优于全胃组（P〈0．05），余指标差异无统计学意义。两组患者术后第3年时生存率差异无统计学意义（P〉0．05）。结论管状胃与全胃代食管食管癌切除术后3年生存率差异无统计学意义。管状胃有益于患者生活质量提高，值得进一步推广，后期将继续关注患者生存状态。Objective To explore the effects of reconstructing method （ narrow gastric tube （NGT） versus whole stomach （WS） ） on health-related quality of life （HRQL）. Methods From 2007 to 2008, 104 patients underwent esophagectomy for cancer in our hospital. To assess HRQL, a questionnaire in reference to the EORTC-QLQ-C30 and the QLQ-OES18 was administered at 3 weeks, 6 months, 1 year, 2 year and 3 years after surgery. They were divided into NGT （ n = 52） and WS （ n = 52 ） groups. To assess HRQL, a questionnaire in references to EORTC-QLQ-C30 and QLQ-OESI8 was administered at 3 weeks, 6 months, 1 year, 2 year and 3 years post-operation. Their clinical data were collected prospectively and follow-up was performed regularly. Results The patients in the NGT group reported significantly （P 〈 0. 05 ） better average scores of HRQL at both 6 months and 1 year. However, no significant difference in average scores of HRQL was found at 3 years. Patients in the NGT group reported significantly （ P 〈 0. 05 ） better scores of reflux at 3 weeks, 6 months and 1 year. Nausea was the only item with significant difference on HRQL at 2 years and 3 years. No significant difference existed between two groups with regards to cumulative survival rate at 3 years. Conclusion No significant difference existed between two groups with regards to cumulative survival rate at 3 years. The patients with gastric tube reconstruction after oncologic esophagectomy present better HRQL. Further studies are warranted to perform survival analysis beyond 3 year post-operation.

关 键 词：食管肿瘤 生活质量 存活率 

分 类 号：R735.1[医药卫生—肿瘤]