本文選題：甲狀腺癌　切入點：手術治療　出處：《浙江大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:研究甲狀腺癌術后患者生存質量變化趨勢并分析與其相關的潛在臨床因素。方法:通過橫斷面研究調查于浙江大學醫(yī)學院附屬第一醫(yī)院經手術確診甲狀腺癌并于門診隨訪的患者的生存質量,描述性分析其生存質量隨術后時間變化趨勢,比較甲狀腺癌行不同術式患者生存質量的差異,通過相關分析和多元回歸分析研究各臨床特征與患者術后生存質量的潛在相關性,并提出預測患者術后生存質量的臨床變量。結果:甲狀腺癌術后患者早期生存質量各領域有下降,乏力、失眠癥狀明顯,后隨著時間變化呈恢復趨勢。甲狀腺手術切除范圍的擴大對患者術后生存質量沒有明顯影響。術后隨訪時間≤12月的患者在術后生存質量的情緒、社會功能領域、總體健康狀況表現更差(P值分別為P=.002,P=.043和P=.006),失眠癥狀也更顯著(P=.023)。術后隨訪時間亦與頸部不適(P=.000)、焦慮(P=.000)多個條目相關,術后12月內主訴上述癥狀明顯,而隨術后時間的變化癥狀得到改善。初次診斷時年齡≥45歲的患者與術后軀體功能、認知功能等多個領域功能的下降有顯著相關(P值分別為P=.012,P=.049)�；颊邚桶l(fā)危險分層和血促甲狀腺激素水平也與術后生存質量受損相關。女性相較男性表現出更明顯的吞咽困難(P=.018)、術后焦慮(P=.002)和認為術后容貌改變(P=.010)。多變量分析中,術后隨訪時間是唯一與總體健康狀況(P=.022)及多項癥狀條目相關的變量。結論:甲狀腺癌患者術后早期生存質量下降,初次診斷時年齡大于45歲、中高復發(fā)危險、TSH水平控制不佳的患者與術后生存質量較差相關,而總體情況隨時間變化呈恢復趨勢。
[Abstract]:Objective: to study the trend of quality of life (QOL) in patients with thyroid cancer after operation and to analyze the potential clinical factors associated with it. Methods: the thyroid gland was confirmed by operation in the first affiliated Hospital of Zhejiang University Medical College by cross-sectional study. Quality of life of cancer patients followed up in outpatient clinics, The quality of life (QOL) of patients with thyroid cancer was compared with the trend of postoperative time, and the potential correlation between clinical features and postoperative quality of life was studied by correlation analysis and multivariate regression analysis. Results: the early quality of life of patients with thyroid cancer was decreased, fatigue and insomnia symptoms were obvious. The extent of thyroidectomy had no significant effect on the postoperative quality of life. The postoperative follow-up time 鈮，

本文編號：1579421