胰腺切除術(shù)后患者短期生活質(zhì)量的前瞻性觀察研究
發(fā)布時間：2018-10-25 19:18
【摘要】：背景胰腺癌是消化系統(tǒng)惡性程度較高的腫瘤之一,其5年生存率僅為5%。根治性手術(shù)切除腫瘤是目前唯一可能延長生存時間的治療措施。傳統(tǒng)醫(yī)療方法只關(guān)注死亡和疾病緩解,忽視了病人對疾病和治療在心理狀態(tài)、主觀感受、生理功能、家人關(guān)系和社會角色等方面的影響。并發(fā)癥發(fā)生率、死亡率和腫瘤復(fù)發(fā)率往往作為評估胰腺癌術(shù)后預(yù)后的指標。然而隨著對患者主觀感受的研究重視,生活質(zhì)量(quality of life,QOL)也逐漸被認可作為評估手術(shù)療效的重要指標之一。目的手術(shù)治療是唯一可以根治胰腺癌的治療方法,但生存時間并不理想,因此胰腺術(shù)后的生活質(zhì)量和生存時間同樣重要。目前國內(nèi)關(guān)于胰腺切除術(shù)后的生活質(zhì)量的研究鮮見報道,本中心率先在國內(nèi)前瞻性地研究胰腺手術(shù)患者的短期生活質(zhì)量變化。方法前瞻性分析2016年1月-2016-10月在南京軍區(qū)南京總醫(yī)院行胰腺切除手術(shù)患者,利用歐洲癌癥研究與治療組織(European Organization for Research and Treatment of Cancer,EORTC)開發(fā)的生活質(zhì)量測定量表(QLQ-C30)和胰腺疾病特異性問卷調(diào)查表(QLQ-PAN26)評估患者術(shù)前和術(shù)后第1、2、3、6月的生活質(zhì)量評分。結(jié)果2016年1月-2016年10月共93例患者于南京軍區(qū)南京總醫(yī)院行胰腺切除術(shù),其中入組72例。所有功能領(lǐng)域得分在術(shù)后1月評分同術(shù)前相比明顯下降(P0.05)。術(shù)后3月角色功能、情緒功能和認知功能同術(shù)前相比均成顯著下降(P0.05)。術(shù)后6月的所有功能領(lǐng)域已基本恢復(fù)至術(shù)前,得分同術(shù)前相比已無統(tǒng)計學(xué)差異(P0.05),其中接近80%的患者恢復(fù)至術(shù)前基線。術(shù)后1月、2月、3月和6月的總健康狀況與術(shù)前相比均顯著上升,P0.05。術(shù)后1月的飲食習(xí)慣改變、食欲喪失、便秘、疲倦、氣促、惡液質(zhì)癥狀均較術(shù)前加重(P0.05)。但肝損害、腹腔積液領(lǐng)域在術(shù)后癥狀改善,術(shù)后2月與術(shù)前基線相比改善明顯(P0.05)。E0RTCQLQ-C30問卷疼痛領(lǐng)域在術(shù)后3月和術(shù)后6月同術(shù)前相比評分明顯下降,P0.05;EORTC QLQ-PAN26問卷疼痛領(lǐng)域在術(shù)后3月與術(shù)前相比才下降明顯,P0.05。結(jié)論胰腺切除手術(shù)后患者生活質(zhì)量短期內(nèi)出現(xiàn)不同程度的下降,但隨后逐步改善,術(shù)后3-6月生活質(zhì)量可恢復(fù)至術(shù)前,部分領(lǐng)域甚至優(yōu)于術(shù)前。
[Abstract]:Background Pancreatic carcinoma is one of the most malignant tumors in the digestive system. The 5-year survival rate is only 5%. Radical resection of tumor is the only treatment that can prolong survival time. Traditional medical methods only focus on death and disease relief, ignoring the influence of patients on mental state, subjective feeling, physiological function, family relationship and social role. The incidence of complications, mortality and tumor recurrence rate are often used as indicators to evaluate postoperative prognosis of pancreatic cancer. However, with the study of patients' subjective feelings, quality of life (quality of life,QOL) has gradually been recognized as one of the important indicators to evaluate the outcome of surgery. Objective Surgical treatment is the only way to cure pancreatic cancer, but the survival time is not ideal, so the quality of life and survival time after pancreatic surgery are equally important. At present, there are few reports about the quality of life after pancreatectomy in our country. Our center has taken the lead in studying the short-term quality of life of patients undergoing pancreatic surgery in China. Methods from January 2016 to October 2016, patients undergoing pancreatic resection in Nanjing General Hospital of Nanjing military region were analyzed prospectively. (European Organization for Research and Treatment of Cancer, was used as a tissue for cancer research and treatment in Europe. The quality of life scale (QLQ-C30) developed by EORTC and the Pancreatic Disease specificity questionnaire (QLQ-PAN26) were used to evaluate the QOL scores of the patients before and after operation. Results from January 2016 to October 2016, 93 patients underwent pancreatectomy in Nanjing General Hospital of Nanjing military region, including 72 cases. The scores of all functional areas decreased significantly in 1 month after operation compared with those before operation (P0.05). Role function, emotional function and cognitive function decreased significantly 3 months after operation (P0.05). After 6 months, all functional areas had recovered to preoperative, and the scores had no statistical difference compared with pre-operation (P0.05), and nearly 80% of the patients recovered to the baseline before operation. The total health status in 1 month, 2 month, 3 month and 6 month after operation was significantly higher than that before operation (P 0. 05. 0. 05). The changes of diet habits, loss of appetite, constipation, tiredness, shortness of breath, and symptoms of cachexia were all worse than those before operation (P0.05). However, the postoperative symptoms in the area of intraperitoneal effusion were improved in the area of liver injury, and the baseline was significantly improved at 2 months after operation (P0.05). The scores in pain area of E0RTCQLQ-C30 questionnaire decreased significantly in 3 months after operation and 6 months after operation compared with preoperative scores (P0.05). The pain area of EORTC QLQ-PAN26 questionnaire decreased significantly 3 months after operation compared with preoperation (P 0.05). Conclusion the quality of life of the patients after pancreatic resection was decreased in a short period of time, but then gradually improved, and the quality of life could be recovered to preoperative in 3 to 6 months postoperatively, and in some areas was even better than that before operation.
【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.9
，
本文編號：2294591
[Abstract]:Background Pancreatic carcinoma is one of the most malignant tumors in the digestive system. The 5-year survival rate is only 5%. Radical resection of tumor is the only treatment that can prolong survival time. Traditional medical methods only focus on death and disease relief, ignoring the influence of patients on mental state, subjective feeling, physiological function, family relationship and social role. The incidence of complications, mortality and tumor recurrence rate are often used as indicators to evaluate postoperative prognosis of pancreatic cancer. However, with the study of patients' subjective feelings, quality of life (quality of life,QOL) has gradually been recognized as one of the important indicators to evaluate the outcome of surgery. Objective Surgical treatment is the only way to cure pancreatic cancer, but the survival time is not ideal, so the quality of life and survival time after pancreatic surgery are equally important. At present, there are few reports about the quality of life after pancreatectomy in our country. Our center has taken the lead in studying the short-term quality of life of patients undergoing pancreatic surgery in China. Methods from January 2016 to October 2016, patients undergoing pancreatic resection in Nanjing General Hospital of Nanjing military region were analyzed prospectively. (European Organization for Research and Treatment of Cancer, was used as a tissue for cancer research and treatment in Europe. The quality of life scale (QLQ-C30) developed by EORTC and the Pancreatic Disease specificity questionnaire (QLQ-PAN26) were used to evaluate the QOL scores of the patients before and after operation. Results from January 2016 to October 2016, 93 patients underwent pancreatectomy in Nanjing General Hospital of Nanjing military region, including 72 cases. The scores of all functional areas decreased significantly in 1 month after operation compared with those before operation (P0.05). Role function, emotional function and cognitive function decreased significantly 3 months after operation (P0.05). After 6 months, all functional areas had recovered to preoperative, and the scores had no statistical difference compared with pre-operation (P0.05), and nearly 80% of the patients recovered to the baseline before operation. The total health status in 1 month, 2 month, 3 month and 6 month after operation was significantly higher than that before operation (P 0. 05. 0. 05). The changes of diet habits, loss of appetite, constipation, tiredness, shortness of breath, and symptoms of cachexia were all worse than those before operation (P0.05). However, the postoperative symptoms in the area of intraperitoneal effusion were improved in the area of liver injury, and the baseline was significantly improved at 2 months after operation (P0.05). The scores in pain area of E0RTCQLQ-C30 questionnaire decreased significantly in 3 months after operation and 6 months after operation compared with preoperative scores (P0.05). The pain area of EORTC QLQ-PAN26 questionnaire decreased significantly 3 months after operation compared with preoperation (P 0.05). Conclusion the quality of life of the patients after pancreatic resection was decreased in a short period of time, but then gradually improved, and the quality of life could be recovered to preoperative in 3 to 6 months postoperatively, and in some areas was even better than that before operation.
【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.9
，
本文編號：2294591
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