食管癌放疗患者支持性照顾需求的预测未满足模型分析  

Analysis on unmet model for predicting supportive care needs of patients with esophageal cancer radiotherapy

作　　者：朱丽[1] 王玲[1] 马瑾璐[1] 高静[1] ZHU Li;WANG Ling;MA Jinlu;GAO Jing(Department of Radiotherapy,First Affiliated Hospital,Xi′an Jiaotong University,Xi′an,Shaanxi 710061,China)

机构地区：[1]西安交通大学医学院第一附属医院放疗科,710061

出　　处：《重庆医学》2021年第13期2198-2202,2207,共6页Chongqing medicine

基　　金：国家自然科学基金项目(81972861);国际科技合作计划项目(S2018-YF-GHMS-0104)。

摘　　要：目的分析并建立食管癌放疗患者支持性照顾需求的预测未满足模型。方法选择2017年4月至2020年4月于该院就诊并行放疗的食管癌患者245例,根据放疗结束后患者支持性照顾需求量表(SCNS-SF34)结果分为无需求组和未满足组。比较两组患者的一般资料、实验室指标、症状评分、情绪评分及疼痛评分等。利用多因素logistic回归分析影响食管癌放疗患者支持性照顾需求未满足的因素。应用R软件建立各影响因素列线图预测模型,并进行验证。结果纳入研究的食管癌放疗患者,其中12例患者脱落处理。233例患者放疗完成后进行SCNS-SF34评定,其中42例患者无需求分为无需求组,191例均有不同的需求未满足,分为未满足组。在食管癌放疗患者SCNS-SF34得分情况中,健康信息维度未满足例数[59.66%(139/233)]最多。两组年龄、性别、心率、清蛋白等指标比较,差异无统计学意义(P>0.05);但无需求组TNM肿瘤分期为Ⅲ、Ⅳ期的和带肠内营养管的例数均少于未满足组(P<0.05),且无需求组安德森胃肠道肿瘤症状量表(MDASI)、焦虑自评量表(SAS)和疼痛视觉模拟评分(VAS)均小于未满足组(P<0.05)。多因素logistic回归分析显示:带肠内营养管(OR=3.981,P=0.028)、MDASI(OR=1.126,P<0.001)、SAS(OR=1.175,P=0.002)和VAS(OR=2.457,P<0.001)是食管癌放疗患者支持性照顾需求未满足的独立影响因素。将与食管癌放疗患者支持性照顾需求未满足的相关因素纳入列线图,预测食管癌放疗患者支持性照顾需求未满足的相关因素的C-index为0.904。结论由带肠内营养管、MDASI、SAS和VAS等因素构建的列线图可用于早期预测食管癌放疗患者支持性照顾需求未满足。Objective To analyze and establish an unmet model for predicting supportive care needs of the patients with esophageal cancer radiotherapy.Methods A total of 245 patients with esophageal cancer undergoing the radiotherapy in this hospital from April 2017 to April 2020 and receiving the radiotherapy were selected.According to the results of the Supportive Care Need Survey(SCNS-SF34)after radiotherapy,the patients were divided into the non-need group and unmet group.The general data,laboratory indicators,symptom scores,mood scores and pain scores were compared between the two groups.The multivariate logistic regression was used to analyze the factors affecting the unmet supportive care needs of the patients with esophageal cancer radiotherapy.The R software was used to establish the predictive model of the nomogram of each influencing factor and verify it.Results Among the included patients with esophageal cancer receiving radiotherapy,12 cases were treated as abscission.The remaining 233 cases were evaluated by SCNS-SF34 after radiotherapy.Forty-two cases had no needs and served as the non-need group,and the remaining 191 cases had different unmet needs and served as the unmet group.In the score of)SCNS-SF34 of the patients with esophageal cancer radiotherapy,the cases number of the health information dimension unmet was maximal[59.66%(139/233)].There was no statistically significant difference in the indexes such as the gender,heart rate and albumin between the two groups(P>0.05),but the number of the cases of tumor TNM stageⅢ,Ⅳand indwelling enteral nutrition tube in the non-need group was less than that in the unmet group(P<0.05),moreover the scores of M.D.Anderson Clinical Checklist(MDASI),self-rating Anxiety Scale(SAS)and Visual Analogue Scale(VAS)in the non-need group were all lower than those in the unmet group(P<0.05).The multivariate Logistic regression analysis showed that indwelling enteral nutrition duct(OR=3.981,P=0.028),MDASI(OR=1.126,P<0.001),SAS(OR=1.175,P=0.002)and VAS(OR=2.457,P<0.001)were th

关 键 词：食管癌 放射治疗 支持性照顾需求量表 症状评分 

分 类 号：R730.55[医药卫生—肿瘤]