早期食管癌患者内镜黏膜下剥离术后生命质量分析  

Analysis of the quality of life in patients with early esophageal cancer after endoscopic submucosal dissection

作　　者：胡瑞芳 田建英[2] 刘书英[1] 郭俊 Hu Ruifang;Tian Jianying;Liu Shuying;Guo Jun(Endoscopy Center,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Hepatobiliary,Pancreatic and Gastric Surgery,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Thoracic Surgery,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院内镜中心,太原030013 [2]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院肝胆胰胃外科,太原030013 [3]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院胸外科,太原030013

出　　处：《肿瘤研究与临床》2023年第8期610-614,共5页Cancer Research and Clinic

摘　　要：目的探讨早期食管癌内镜黏膜下剥离术(ESD)后患者的生命质量及相关影响因素。方法对山西省肿瘤医院2022年1月至2022年7月行ESD的167例早期食管癌患者进行问卷调查,采用欧洲癌症研究与治疗组织生命质量评估核心量表(EORTC QLQ-C30)和食管癌补充量表(EORTC QLQ-OES18)比较术前及术后1、6个月不同临床特征患者的生命质量,并采用多因素logistic回归分析患者术后6个月生命质量的影响因素。结果EORTC QLQ-C30示,患者术后1、6个月躯体功能、角色功能、社会功能3个维度得分均低于术前,差异均有统计学意义(均P<0.05);症状领域的呼吸困难、便秘、恶心呕吐、疲劳、经济状况得分均高于术前,差异均有统计学意义(均P<0.05)。EORTC QLQ-OES18示,患者术后1、6个月咽口水困难、梗阻、进食主动性差、口干、咳嗽得分均高于术前,差异均有统计学意义(均P<0.05);吞咽困难得分术后1个月高于术前,但术后6个月低于术前,差异均有统计学意义(均P<0.05);消化不良得分术后1、6个月均低于术前,差异均有统计学意义(均P<0.05)。多因素分析显示,病变周径>1/2周(病变周径>1/2比病变周径≤1/2:OR=2.072,95%CI 1.536~2.796,P<0.05)与术后行食管狭窄扩张术(行食管狭窄扩张术比未行食管狭窄扩张术:OR=2.193,95%CI 1.429~2.789,P<0.05)是影响患者术后6个月生命质量的独立危险因素。结论早期食管癌患者ESD后生命质量较术前降低,主要表现在躯体功能、角色功能、社会功能及症状领域,病变周径与是否行食管狭窄扩张术是影响患者术后生命质量的因素。Objective To explore the quality of life(QOL)and the related influencing factors of patients with early esophageal cancer after endoscopic submucosal dissection(ESD).Methods A questionnaire survey was conducted in 167 early esophageal cancer patients who underwent ESD in Shanxi Province Cancer Hospital from January 2022 to July 2022.European Organization for Research and Treatment of Cancer Quality of Life Assessment Core Scale(EORTC QLQ-C30)and the Esophageal Cancer Supplementary Scale(EORTC QLQ-OES18)were used to compare QOL of patients with different clinical characteristics before surgery,1 month after surgery and 6 months after surgery,And multiple logistic regression analysis was used to analyze the influencing factors of patients'QOL at 6 months after surgery.Results EORTC QLQ-C30 showed that the scores of the patients'physical function,role function,and social function at 1 month and 6 months after surgery were lower than those before surgery,and the differences were statistically significant(all P<0.05).The scores of dyspnea,constipation,nausea and vomiting,fatigue,and economic status in the symptom area were higher than those before surgery,and the differences were statistically significant(all P<0.05).According to EORTC QLQ-OES18,the scores of difficulty in swallowing oral fluid,obstruction,poor eating initiative,dry mouth,and cough at 1 month and 6 months after surgery were higher than those before surgery,and the differences were statistically significant(all P<0.05).The score of dysphagia at 1 month after surgery was higher than that before surgery,while the score at 6 months after surgery was lower than that before surgery,and the differences were statistically significant(all P<0.05).The score of dyspepsia at 1 month and 6 months after surgery was lower than that before surgery,and the difference was statistically significant(all P<0.05).Multivariate analysis showed that the lesion perimeter>1/2 perimeter(lesion perimeter>1/2 perimeter vs.lesion perimeter≤1/2 perimeter:OR=2.072,95%CI 1.536-2.796

关 键 词：食管肿瘤 内镜黏膜下剥离术 生命质量 

分 类 号：R735.1[医药卫生—肿瘤]