胸腔镜辅助肺癌切除术后生活质量的研究  

A Study on Quality of Life after Thoracoscopic Assistant Lobectomy for Lung Cancer

作　　者：曾剑[1] 刘金石[1] 

机构地区：[1]浙江省肿瘤医院胸部肿瘤外科,杭州310004

出　　处：《中国肺癌杂志》2014年第3期209-214,共6页Chinese Journal of Lung Cancer

摘　　要：背景与目的传统的肺癌根治手术创伤大,胸腔镜下手术能减少手术创伤,有望改善肺癌患者术后生命质量(quality of life,QOL)。本研究旨在探讨胸腔镜下肺癌根治术对患者QOL的影响。方法使用由欧洲癌症研究与治疗组织(European Organization for Research and Treatment,EORTC)开发的质量核心问卷量表(Quality of LifeCore 30 Questionnaire,QLQ-C30)和针对肺癌患者的补充量表(Quality of Life-Lung Cancer 13 Questionnaire,QLQ-LC13)对60例分别接受胸腔镜和常规开胸肺癌根治术的非小细胞肺癌(non-small cell lung cancer,NSCLC)患者从术前3天至术后24周内的QOL进行评价。结果 60例患者一共收回问卷215份,其余25份失访。所有患者的QOL在术后3天时均出现明显下降,常规开胸组和胸腔镜组术前、后3天的总体QOL平均得分分别为:87.8±10.3 vs 38.3±13.1(P<0.001)和82.7±9.6 vs 56.3±14.8(P<0.001)。随后,所有患者的QOL开始回升。常规开胸组患者的QOL下降更为明显,术后3天的总体QOL得分明显低于胸腔镜组(P=0.012,9),术后24周时仍然不能恢复至术前水平(P=0.0124)。胸腔镜组术后QOL下降相对较小,术后24周时大部分指标恢复至术前水平。结论胸腔镜下肺癌根治术创伤小,恢复快,术后QOL高于传统开胸手术,是一种较为可取的肺癌术式。Background and objective Conventional radicaJ surgeries for lung cancer incur a large amount of trauma, thoracoscopic surgeries can reduce trauma, and hopefully improve patients＇ postoperative quality of life （QOL）. The aim of this study is to evaluate the impact of thoracoscopic radical surgeries on quality of life of patients with non-small cell lung cancer （NSCLC）. Methods Use Quality of Life-Core 30 Questionnaire （QLQ-C30） which was exploited by European Organization for Research and Treatment （EORTC） and Quality of Life-Lung Cancer 13 Questionnaire （QLQ-LC13） which is the supplementary questionnaire according to the lung cancer patients to evaluate QOL of 60 NSCLC patients in thoracoscopic surgery group and conventional surgery group from 3 days before operation to 24 weeks after operation. Results A total of 215 questionnaires were collected from 60 patients; 25 postoperative questionnaires were not completed because patients could not be contacted for follow-up visits. QOL declined markedly in all patients at 3 days postoperatively; preoperative and 3-day postoperative global QOL scores in the conventional surgery and thoracoscopic surgery group were 87.8±10.3 vs 38.3± 13.1 （P〈0.001） and 82.7±9.6 vs 56.3±14.8 （P〈0.001）, respectively. Thereafter, QOL recovered gradually in all patients. Patients who underwent open surgery showed the most pronounced decline in QOL; global scores were lower in this group than in the thoracoscopic surgery group （B=0.012,9） at 3 days postoperatively and was not restored to the preoperative level at 24 weeks postoperatively （P=0.012,4）. QOL declined less in patients undergoing thoracoscopic surgery, and most indices had recovered to preoperative levels at 24 weeks postoperatively. Conclusion With the advantages of small trauma, faster recovery and higher postoperative QOL, thoracoscopic surgery is a preferable lung cancer surgery.

关 键 词：肺肿瘤 生命质量 胸腔镜 

分 类 号：R734.2[医药卫生—肿瘤]