本文選題：乳腺癌 + 乳房重建��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：背景:多種因素影響著乳腺癌患者對(duì)乳房重建的選擇。乳腺癌患者選擇乳房重建與否,對(duì)其本身的社會(huì)心理有極大的影響。目前我省對(duì)乳腺癌患者選擇乳房重建的影響因素知之甚少,本文目的旨在分析影響乳腺癌患者選擇乳房重建的相關(guān)因素。材料方法:我們選擇從2016年4月至2016年12月這一連續(xù)的時(shí)間段內(nèi)在山西大醫(yī)院乳腺外科診治的乳腺癌患者為研究對(duì)象,包括:確診為乳腺癌尚未行手術(shù)治療的患者、乳腺癌術(shù)后治療的患者、門診復(fù)查的患者,共收集106名患者信息,內(nèi)容包括:(1)基本信息�；颊叩某錾暝隆⒙殬I(yè)、文化程度、婚姻狀況、家庭收入狀況、住院費(fèi)用報(bào)銷類別、是否手術(shù)情況;(2)手術(shù)后患者情況�；颊叩氖中g(shù)治療醫(yī)院、手術(shù)醫(yī)生是否介紹過(guò)“乳房重建”、術(shù)后時(shí)間、手術(shù)方式、是否行前哨淋巴結(jié)活檢、是否行腋窩淋巴結(jié)清掃、病理分期及分型、術(shù)后是否有并發(fā)癥、是否對(duì)自身形象是否滿意、術(shù)后輔助治療。(3)乳房重建相關(guān)問(wèn)題。是否了解乳房重建、是否選擇乳房重建、選擇重建的時(shí)機(jī)及方式、不選擇重建的原因。所收集數(shù)據(jù)采用SPSS19.0進(jìn)行分析,年齡采用均數(shù)±標(biāo)準(zhǔn)差表示,計(jì)數(shù)資料采用例數(shù)(構(gòu)成比)表示,涉及到的統(tǒng)計(jì)方法有t檢驗(yàn)、卡方分析、多元logistic回歸。結(jié)果:本研究共向106例患者發(fā)放調(diào)查問(wèn)卷,回收有效問(wèn)卷106份,問(wèn)卷完成率為100%。患者年齡中位數(shù)為52歲(范圍為23至76歲),平均年齡為51.24±11.12歲。在多變量分析中,我們將文化程度、家庭收入、手術(shù)治療醫(yī)院、手術(shù)方式、術(shù)后對(duì)自身滿意度、年齡這六項(xiàng)有統(tǒng)計(jì)學(xué)意義的因素作為多因素分析的自變量,結(jié)果顯示,僅有家庭收入、年齡及手術(shù)治療醫(yī)院類別與患者選擇乳房重建有顯著的相關(guān)性。家庭收入越多選擇重建的概率越高,收入≥10000元的人相對(duì)于2000元的人選擇重建的可能性是5.0倍(OR 5.0 95%CI 3.835-6.261 P=0.008);年齡52歲組相對(duì)于大于52歲組選擇重建的可能性是1.3倍(OR 0.8 95%CI 0.706-0.870 P=0.008);在三甲綜合性教學(xué)醫(yī)院(OR 47.4 95%CI 44.686-50.040 P=0.005)治療的患者相對(duì)其他患者選擇乳房重建的概率越高,三級(jí)綜合醫(yī)院就醫(yī)患者選擇重建的可能性是其他醫(yī)院的47.4倍。討論:雖然近些年乳房重建率逐漸增高,但是選擇乳房重建的患者仍然較少。本研究顯示,年齡、家庭經(jīng)濟(jì)狀況、患者接受手術(shù)治療的醫(yī)院類型是影響患者選擇乳房重建的重要因素。
[Abstract]:Background: a variety of factors affect breast cancer patients' choice of breast reconstruction. Whether breast cancer patients choose breast reconstruction or not has great influence on their own social psychology. At present, we know very little about the influencing factors of breast reconstruction in breast cancer patients. The purpose of this paper is to analyze the related factors affecting breast cancer patients' choice of breast reconstruction. Materials: we selected breast cancer patients who had been diagnosed and treated in breast surgery in Shanxi Great Hospital from April 2016 to December 2016, including those diagnosed as breast cancer patients who had not received surgical treatment for breast cancer. A total of 106 patients with breast cancer treated after operation and outpatients with outpatient reexamination were collected, including the basic information of: 1). Year of birth, occupation, education, marital status, family income, category of reimbursement for hospital expenses, whether or not the operation was performed. The patient's surgical treatment hospital, surgeon has introduced "breast reconstruction", postoperative time, operation method, whether to perform sentinel lymph node biopsy, whether to perform axillary lymph node dissection, pathological stage and classification, and whether there are complications after operation. Whether satisfied with self-image, postoperative adjuvant treatment. 3) breast reconstruction related problems. Whether to understand breast reconstruction, whether to choose breast reconstruction, to choose the time and method of reconstruction, not to choose the reasons for reconstruction. The collected data are analyzed by SPSS19.0, the age is expressed by mean 鹵standard deviation, and the counting data is expressed by examples (composition ratio). The statistical methods involved are t-test, chi-square analysis and multivariate logistic regression. Results: a total of 106 patients were investigated and 106 valid questionnaires were collected. The completion rate of the questionnaires was 100. The median age of the patients was 52 years (ranging from 23 to 76 years, mean age was 51.24 鹵11.12 years). In the multivariate analysis, we used six factors, such as education level, family income, surgical treatment hospital, operation mode, postoperative satisfaction and age, as independent variables of multivariate analysis. Only family income, age and type of surgical treatment hospital were significantly correlated with patients' choice of breast reconstruction. The higher the household income, the more likely it is to choose to rebuild. The odds of people earning more than 10000 yuan to choose reconstruction were 5.0 times higher than those of 2000 yuan, OR 5.0 95%CI 3.835-6.261 P0.008, OR 0.8 95%CI 0.706-0.870 P0. 008; OR = 1.3-0.706-0.870 P0. 008; OR = 1.3x; OR = 0.706-0.870 P0. 008P; OR = 1.3x; OR = 0.706-0.870 P0. 008P; 47.4 95%CI 44.686-50.040 P0. 005) the higher the probability of breast reconstruction in patients treated with 95%CI 44.686-50.040 P0. 005, Patients in tertiary general hospitals are 47.4 times more likely to choose reconstruction than other hospitals. Discussion: although breast reconstruction rates have increased in recent years, fewer patients choose breast reconstruction. This study shows that age, family financial status, and the type of hospital in which patients receive surgical treatment are important factors affecting the choice of breast reconstruction.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.9

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