老年食管癌患者放疗期间生活质量的动态观察  

Dynamic observation on quality of life in elderly patients with esophageal cancer during radiotherapy

作　　者：吴绒 侯丽华 任亚如 Wu Rong;Hou Lihua;Ren Yaru(Sixth Ward,Department of Thoracic Surgery,Second Affiliated Hospital,Air Force Medical University,Xi′an 710038,China)

机构地区：[1]空军军医大学第二附属医院胸腔外科六病区,西安710038

出　　处：《中华老年多器官疾病杂志》2025年第2期93-98,共6页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：国家自然科学基金(82270084);陕西省重点研发计划项目(2021KW-61)。

摘　　要：目的观察老年食管癌患者放疗期间生活质量动态变化及其相关影响因素。方法开展前瞻性研究,将2022年1月至2023年1月空军军医大学第二附属医院收治的123例老年食管癌放疗患者纳为研究对象,分别在其放疗初(放疗后第1天)、中(放疗4周后)、末(放疗结束时)期,采用癌症患者生活质量量表(QLQ-C30)调查患者生活质量,采用医院焦虑及抑郁量表(HAD)调查患者是否存在焦虑抑郁情绪,采用简易应对方式问卷(SCSQ)调查患者应对方式,采用患者主观整体评估(PG-SGA)量表评估患者基线营养状态。采用SPSS 22.0软件进行数据分析。采用多元线性回归模型分析影响患者放疗期间生活质量的相关因素。结果123例老年食管癌放疗患者中有10例因各种放疗并发症放弃治疗,剩余113例患者均完成放疗计划与相关调查。放疗前,放疗初、中、末期,老年食管癌患者QLQ-C30量表中躯体功能、角色功能、情绪功能、社会功能以及总健康得分均呈依次下降趋势,不同时间点两两比较,差异均有统计学意义(均P<0.05);疲劳、疼痛、恶心呕吐,以及睡眠障碍、食欲下降、呼吸困难、经济状况得分均呈依次上升趋势,组间两两比较,差异均有统计学意义(均P<0.05)。行多元线性回归分析提示,家庭月收入(β=0.311;P<0.001)、SCSQ(积极应对)(β=0.069;P=0.036)对患者放疗初期QLQ-C30量表得分有正向预测作用,临床分期(β=-0.243;P<0.001)、HAD(焦虑)(β=-0.271;P<0.001)对其放疗初期QLQ-C30量表得分有负向预测作用,这些变量共同解释放疗初期QLQ-C30量表得分42.30%的变异;PG-SGA(≥9分)(β=-0.766;P<0.001)、HAD(焦虑)(β=-0.183;P<0.001)对老年食管癌患者放疗中期QLQ-C30量表得分有负向预测作用,精确放疗(β=0.322;P<0.001)、SCSQ(积极应对)(β=0.671;P<0.001)对其中期QLQ-C30量表得分有正向预测作用,以上变量共同解释中期QLQ-C30量表得分51.40%的变异;PG-SGA(≥9分)(β=-0.173;PObjective To observe the dynamic changes in quality of life and its related influencing factors in elderly patients with esophageal cancer during radiotherapy.Methods A prospective trial was conducted on 123 elderly patients with esophageal cancer undergoing radiotherapy in our hospital from January 2022 to January 2023.In the early,middle and late stages of radiotherapy(at 1 d,4 weeks after and the end of radiotherapy),quality of life questionnaire core-30(QLQ-C30),hospital anxiety and depression(HAD)scale,simplified coping style questionnaire(SCSQ)and patient-generated subjective global assessment(PG-SGA)scale were used to survey the quality of life,having anxiety and depression,coping styles and baseline nutritional status in the patients.SPSS 22.0 software was used for data analysis.Multivariate linear regression model was applied to analyze the related factors affecting the quality of life of these patients during radiotherapy.Results Among the 123 elderly patients,10 gave up due to various radiotherapeutic complications,and the remaining 113 cases completed the radiotherapy plan and related investigation.The scores of physical function,role function,emotional function,social function and total health score of QLQ-C30 scale showed downward trends in turn at the time points of before and in the early,middle and late stages of radiotherapy,and the differences between any two time points were statistically significant(all P<0.05).The scores of fatigue,pain,nausea and vomiting,as well as sleep disorders,loss of appetite,dyspnea and economic status were in upward trends in turn,and there were significant differences between the two time points(all P<0.05).Multivariate linear regression analysis indicated that family monthly income(β=0.311;P<0.001)and SCSQ(positive coping)(β=0.069;P=0.036)had a positive predictive effect,and clinical stage(β=-0.243;P<0.001)and HAD(anxiety)(β=-0.271;P<0.001)had a negative predictive effect on the QLQ-C30 scale score in the early stage of radiotherapy,and the above variables joi

关 键 词：老年人 食管癌 放疗 生活质量 动态观察 

分 类 号：R735.1[医药卫生—肿瘤] R592[医药卫生—临床医学]