本文選題：鼻咽癌 + 局部晚期��； 參考：《廣西醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的描述局部晚期鼻咽癌同期放化療患者不同時(shí)間段的營養(yǎng)狀況、生活質(zhì)量及免疫功能并進(jìn)行比較分析，探討三者間的相關(guān)性。 方法2010年10月至2011年3月，對(duì)136例局部晚期鼻咽癌同期放化療患者采用問卷調(diào)gＨ炕頰咴諶朐菏蓖瓿梢話闋柿鮮占�、简易营养铺m畚示恚∕NA)、生活質(zhì)量核心問卷(QLQ-C3())、頭頸部癌癥生活質(zhì)量量表(QLQ-HN35)以及生化和免疫指標(biāo)測定；并分別對(duì)全部患者于同期放化療第1天，第7天，第14天，第21天，第28天，第35天，第42天，第49天，第56天，治療后3個(gè)月和6個(gè)月，進(jìn)行生活質(zhì)量測評(píng)、癥狀記錄和體重測量；于第14天，第28天，第42天，，第56天，治療后3個(gè)月和6個(gè)月，分別對(duì)患者進(jìn)行營養(yǎng)狀況和生化、免疫指標(biāo)測評(píng)。所有資料應(yīng)用SSPS13.0軟件進(jìn)行描述性和相關(guān)性統(tǒng)計(jì)分析。 結(jié)果 1. 局部晚期鼻咽癌同期放化療患者不同時(shí)間段營養(yǎng)狀況的差異有統(tǒng)計(jì)學(xué)意義（P〈0.05)。 2. 局部晚期鼻咽癌同期放化療患者不同時(shí)間段生活質(zhì)量的差異有統(tǒng)計(jì)學(xué)意義（P0.05)。 3. 局部晚期鼻咽癌同期放化療患者不同時(shí)間段的免疫功能的差異有統(tǒng)計(jì)學(xué)意義（P0.05),治療結(jié)束后3個(gè)月患者細(xì)胞免疫中CM/CD8比值和體液免疫中IgM與治療期間差異有統(tǒng)計(jì)學(xué)意義外（P0.05)，細(xì)胞免疫中CD3、 CD4、CD8和體液免疫中IgA、IgG五項(xiàng)均與治療期間差異無統(tǒng)計(jì)學(xué)意義（P0.05);治療結(jié)束后6個(gè)月患者的免疫功能與治療期間的差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 4. 單因素分析：局部晚期鼻咽癌同期放化療患者不同時(shí)間段生活質(zhì)量中疲勞（r=-0.672)、惡心嘔吐（r=-0.388).疼痛（r=-0.454)、失眠（r=-0.386)、食欲喪失（r=-0.596)、便秘（r=-0.286)、腹瀉（r=-0.218)、經(jīng)濟(jì)困難（r=-0.555)、口干（r=-0.430)、唾液粘稠（r=-0.177)、止痛藥物(r=-0.166)、營養(yǎng)支持（r=-0.213)、與營養(yǎng)狀況負(fù)相關(guān)；軀體功能(r=0.619)、角色功能（r=0.710)、情緒功能（r=0.541)、認(rèn)知功能(r=0.701)、總體健康狀況（r=0.727)、吞咽（r=0.383)、感覺（r=0.375)、社交進(jìn)食（r=0.310)、社交接觸（r=0.372)、體重變化（r=0.107)與營養(yǎng)狀況正相關(guān)；張口困難（r=0.030)、咳嗽（r=-0.061)、感覺生�。╮二-0.045)與營養(yǎng)狀況無相關(guān)；局部晚期鼻咽癌同期放化療患者不同時(shí)間段免疫功能中IgA (r=0.354)、 IgG (r:(0.599)、 IgM (r=0.341)、 CDS (r=0.377)、CD4(r=0.240)、 CDS (r=0.367)與營養(yǎng)狀況正相關(guān)；CM/CD8(r=-0.159)與營養(yǎng)狀況負(fù)相關(guān)。 5. 多因素分析：由總體健康狀況、認(rèn)知功能、止痛藥物、情緒功能、IgG、疲勞、腹瀉、IgA、口干、唾液粘稠、食欲喪失、失眠參與構(gòu)建了多重回歸模型，與營養(yǎng)狀況有線性關(guān)系(P0.05)，是影響營養(yǎng)狀況有統(tǒng)計(jì)學(xué)意義的因素。 結(jié)論 1. 局部晚期鼻咽癌患者在整個(gè)治療期間患者營養(yǎng)狀況呈逐步下降趨勢，持續(xù)時(shí)間長。 2. 局部晚期鼻咽癌患者同期放化療過程中整體生活質(zhì)量和免疫功能持續(xù)下降；治療結(jié)束后6個(gè)月，患者生活質(zhì)量有改善的趨勢，但未能恢復(fù)到治療前；免疫功能改善不明顯。 3. 局部晚期鼻咽癌同期放化療患者的營養(yǎng)狀況與總體健康狀況、認(rèn)知功能、止痛藥物、情緒功能、IgG、疲勞、腹瀉、IgA、口干、唾液粘稠、食欲喪失、失眠等多個(gè)因素相關(guān)。
[Abstract]:Objective to describe the nutritional status, quality of life and immune function of patients with locally advanced nasopharyngeal carcinoma during the period of concurrent chemoradiotherapy, and to compare and analyze the correlation between the three.
Methods from October 2010 to March 2011, 136 patients with locally advanced nasopharyngeal carcinoma were treated with G? H? Do not treat all patients with first days, seventh days, fourteenth days, twenty-first days, twenty-eighth days, thirty-fifth days, forty-second days, forty-ninth days, fifty-sixth days, 3 months and 6 months after treatment. The quality of life, symptom records and weight measurements are carried out on the day of fourteenth, twenty-eighth days, forty-second days, postoperative months and months. Biochemical and immune indicators were evaluated. All data were analyzed by descriptive statistics and correlation analysis using SSPS13.0 software.
Result
1. the nutritional status of patients with locally advanced nasopharyngeal carcinoma who had concurrent chemoradiotherapy at different time periods was statistically significant (P < 0.05).
2. the quality of life of patients with locally advanced nasopharyngeal carcinoma who had concurrent chemoradiotherapy at different times was statistically significant (P0.05).
3. the difference of immune function of patients with local advanced nasopharyngeal carcinoma during the same period of radiotherapy and chemotherapy was statistically significant (P0.05). The difference of CM/CD8 ratio and IgM in humoral immunity in the 3 months after the treatment was statistically significant (P0.05). CD3, CD4, CD8, and humoral immunity were IgA and IgG five items in cellular immunity There was no significant difference between the two groups (P0.05), and there was a significant difference in the immune function between the 6 months after treatment and the treatment period (P0.05).
4. single factor analysis: fatigue (r=-0.672), nausea and vomiting (r=-0.388), pain (r=-0.454), insomnia (r=-0.386), loss of appetite (r=-0.596), constipation (r=-0.286), r= -0.218 (r= -0.218), r=-0.555 (r=-0.555), dry mouth (r=-0.430), saliva sticky (r=-0.177), analgesic drugs (r=-0.166), nutritional support (r=-0.213), negative correlation with nutritional status; body function (r=0.619), role function (r=0.710), emotional function (r=0.541), cognitive function (r=0.701), overall health status (r=0.727), swallowing (r=0.383), sense (r= 0.375), social eating (r=0.310), social contact (r=0.372), body weight change (r=0.107) and nutrition status is positively related. R=0.030, r=-0.061, and feeling ill (r two -0.045) are not related to nutritional status; IgA (r=0.354), IgG (r: (0.599), IgM (r=0.341), CDS (R)) in patients with locally advanced nasopharyngeal carcinoma during the same period of radiotherapy and chemotherapy are positively related to nutritional status; The nutritional status was negatively correlated.
5. multi factor analysis: the multiple regression model was constructed from the overall health status, cognitive function, analgesic drugs, emotional function, IgG, fatigue, diarrhea, IgA, dry mouth, saliva stickily, loss of appetite, and insomnia, and had a linear relationship with nutritional status (P0.05), which was a significant factor affecting the nutritional status.
conclusion
1. the nutritional status of patients with locally advanced nasopharyngeal carcinoma decreased gradually during the whole treatment period and lasted for a long time.
2. in patients with locally advanced nasopharyngeal carcinoma, the overall quality of life and immune function continued to decrease during the concurrent chemoradiotherapy, and the quality of life improved in the 6 months after the end of the treatment, but the immune function was not improved obviously before the treatment was restored to the treatment.
3. the nutritional status of patients with locally advanced nasopharyngeal carcinoma during concurrent chemoradiotherapy is related to the overall health status, cognitive function, analgesic drugs, emotional function, IgG, fatigue, diarrhea, IgA, dry mouth, saliva sticky, loss of appetite, insomnia and so on.

【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R739.63

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