發(fā)布時(shí)間：2018-03-07 13:07

  本文選題：甲狀腺癌　切入點(diǎn)：手術(shù)治療　出處：《浙江大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:研究甲狀腺癌術(shù)后患者生存質(zhì)量變化趨勢(shì)并分析與其相關(guān)的潛在臨床因素。方法:通過橫斷面研究調(diào)查于浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院經(jīng)手術(shù)確診甲狀腺癌并于門診隨訪的患者的生存質(zhì)量,描述性分析其生存質(zhì)量隨術(shù)后時(shí)間變化趨勢(shì),比較甲狀腺癌行不同術(shù)式患者生存質(zhì)量的差異,通過相關(guān)分析和多元回歸分析研究各臨床特征與患者術(shù)后生存質(zhì)量的潛在相關(guān)性,并提出預(yù)測(cè)患者術(shù)后生存質(zhì)量的臨床變量。結(jié)果:甲狀腺癌術(shù)后患者早期生存質(zhì)量各領(lǐng)域有下降,乏力、失眠癥狀明顯,后隨著時(shí)間變化呈恢復(fù)趨勢(shì)。甲狀腺手術(shù)切除范圍的擴(kuò)大對(duì)患者術(shù)后生存質(zhì)量沒有明顯影響。術(shù)后隨訪時(shí)間≤12月的患者在術(shù)后生存質(zhì)量的情緒、社會(huì)功能領(lǐng)域、總體健康狀況表現(xiàn)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(shù)后隨訪時(shí)間亦與頸部不適(P=.000)、焦慮(P=.000)多個(gè)條目相關(guān),術(shù)后12月內(nèi)主訴上述癥狀明顯,而隨術(shù)后時(shí)間的變化癥狀得到改善。初次診斷時(shí)年齡≥45歲的患者與術(shù)后軀體功能、認(rèn)知功能等多個(gè)領(lǐng)域功能的下降有顯著相關(guān)(P值分別為P=.012,P=.049)。患者復(fù)發(fā)危險(xiǎn)分層和血促甲狀腺激素水平也與術(shù)后生存質(zhì)量受損相關(guān)。女性相較男性表現(xiàn)出更明顯的吞咽困難(P=.018)、術(shù)后焦慮(P=.002)和認(rèn)為術(shù)后容貌改變(P=.010)。多變量分析中,術(shù)后隨訪時(shí)間是唯一與總體健康狀況(P=.022)及多項(xiàng)癥狀條目相關(guān)的變量。結(jié)論:甲狀腺癌患者術(shù)后早期生存質(zhì)量下降,初次診斷時(shí)年齡大于45歲、中高復(fù)發(fā)危險(xiǎn)、TSH水平控制不佳的患者與術(shù)后生存質(zhì)量較差相關(guān),而總體情況隨時(shí)間變化呈恢復(fù)趨勢(shì)。
[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(hào)：1579421