本文關(guān)鍵詞： 塵肺 生存質(zhì)量 生存分析 共病 評(píng)價(jià)　出處：《武漢科技大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的 探討塵肺患者不同期別生存年限的差異，研究共病對(duì)塵肺生存質(zhì)量的影響，為制定積極有效的醫(yī)療保健措施，進(jìn)一步完善傷殘鑒定標(biāo)準(zhǔn)，延長(zhǎng)患者壽命、提高生命質(zhì)量提供標(biāo)準(zhǔn)和科學(xué)依據(jù)。拓展塵肺生存質(zhì)量的評(píng)價(jià)指標(biāo)，力求建立全面科學(xué)的評(píng)價(jià)體系。 方法 對(duì)萊蕪地區(qū)281例塵肺患者資料采用壽命表法和Kaplan-Meier法計(jì)算生存率，多因素分析采用Cox比例風(fēng)險(xiǎn)模型篩選影響預(yù)后因素，P0.05為差異有統(tǒng)計(jì)學(xué)意義。190例存活塵肺患者中，對(duì)150例進(jìn)行了肺功能評(píng)價(jià)、營(yíng)養(yǎng)狀況評(píng)價(jià)、共病分析，并就生存質(zhì)量和諸因素作回歸分析。 結(jié)果 塵肺累積中位數(shù)生存時(shí)間為19.18年，叁期塵肺患者的生存時(shí)間較壹期和貳期短，塵肺期別、合并癥和共病分別是塵肺生存時(shí)間的獨(dú)立影響因子。老年塵肺患者中以中度肺功能不全者居多，占43.3%，有88.7%的患者存在不同程度的肺功能損害。生存質(zhì)量與共病、營(yíng)養(yǎng)狀況之間存在相關(guān)關(guān)系。利用回歸方程建立了生存質(zhì)量與FVC、MEF75%、FEV1%、營(yíng)養(yǎng)分、共病分五項(xiàng)指標(biāo)之間的關(guān)系。隨著肺功能損傷的加重，營(yíng)養(yǎng)狀況存在下降趨勢(shì)，其中亞營(yíng)養(yǎng)不良居多。通過(guò)方差分析，，認(rèn)為在營(yíng)養(yǎng)狀況方面，肺功能重度損害者與正常者之間存在顯著性差異。逐步擬合回歸方程為：Y=0.710+0.350X_1+0.161X_2+0.209X_3(X_1代表年齡等級(jí)，X_2代表肺功能等級(jí)，X_3代表營(yíng)養(yǎng)狀況等級(jí)) 結(jié)論 共病方法在塵肺評(píng)價(jià)中切實(shí)可行，意義重大。共病分級(jí)以中度居多，無(wú)共病者最少，大多數(shù)人都存在著不同程度的其他疾病。積極治療共病、預(yù)防或減少合并癥是延緩塵肺晉期、延長(zhǎng)生存時(shí)間的關(guān)鍵。塵肺生存質(zhì)量的多因素評(píng)價(jià)科學(xué)有效。
[Abstract]:Purpose To explore the difference of life span of pneumoconiosis patients in different periods, to study the influence of co-disease on the quality of life of pneumoconiosis, to establish positive and effective medical and health care measures, to further improve the standard of disability identification, and to prolong the life span of patients with pneumoconiosis. To improve the quality of life to provide the standard and scientific basis to expand the quality of life of pneumoconiosis evaluation indicators and strive to establish a comprehensive and scientific evaluation system. Method The survival rate of 281 patients with pneumoconiosis in Laiwu area was calculated by life table method and Kaplan-Meier method. The prognostic factors were screened by Cox proportional risk model in multivariate analysis. The difference was statistically significant (P0.05) among 190 patients with surviving pneumoconiosis, 150 cases were evaluated with pulmonary function, nutritional status, co-disease analysis, and regression analysis was made on the quality of life and various factors. Results The median survival time of pneumoconiosis was 19.18 years. The survival time of patients with stage 3 pneumoconiosis was shorter than that of stage 1 and stage 2, and the stage of pneumoconiosis was different. Complications and syndromes were independent factors of survival time of pneumoconiosis. Moderate pulmonary insufficiency was the most common factor in elderly patients with pneumoconiosis, accounting for 43.3%. 88.7% of the patients had different degrees of lung function damage. There was a correlation between quality of life and co-disease and nutritional status. The regression equation was used to establish the relationship between quality of life and FVC MEF 75%. FEV1, nutritional score, total disease of the relationship between the five indicators. With the exacerbation of lung function injury, nutritional status has a downward trend, in which submalnutrition is the majority. Through ANOVA. In terms of nutritional status. There was significant difference between the patients with severe lung function damage and the normal subjects. The stepwise fitting regression equation was: 1: YY0.710 0.350X1 0.161XS 20. 209X3 (. X1 represents the age class. X2 for lung function grade X3 for nutritional status) Conclusion The method of comorbidity is feasible and significant in the evaluation of pneumoconiosis. The degree of comorbid diseases is mostly moderate and the least is non-comorbid. Most people have other diseases of different degrees. Prevention or reduction of complications is the key to delay the stage of pneumoconiosis and prolong the survival time. Multi-factor evaluation of pneumoconiosis quality of life is scientific and effective.
【學(xué)位授予單位】：武漢科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R135.2

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本文編號(hào)：1459956