肺癌高龄患者术后4个月内症状和生活质量的变化及其影响因素

摘要

目的：研究肺癌高龄患者手术后症状与生活质量变化特点及其影响因素。方法选取手术治疗的肺癌患者146例作为研究对象，采用焦虑自评量表 SAS、抑郁自评定量表 SDS 和欧洲癌症研究与治疗协作组生活质量核心问卷（EORTC QLQ-C30）评价研究对象焦虑、抑郁情况、生活质量及症状。数据分析采用方差分析和多元线性回归的方法。结果SAS 及 SDS 结果显示术后1、2和4个月内患者 SAS 及 SDS 得分逐渐降低（F ＝61．215、23．752，均 P ＜0．05）。EORTC QLQ-C30问卷结果显示术后4个月内生理、角色、社会、情绪及全身健康状况维度得分逐渐增高（F ＝9．195、6．868、10．610、16．470、6．472：均 P ＜0．05）；疲劳、疼痛、呼吸困难、食欲丧失、失眠得分逐渐降低（F ＝9．541、40．216、5．739、10．481、7．384：均 P ＜0．05）；认知、恶心或呕吐、腹泻、便秘、经济困难等方面差异无统计学意义（P ＞0．05）。多元线性回归结果显示术后第1个月症状的影响因素为焦虑、吸烟状况和手术方式，生活质量影响因素为吸烟状况、抑郁及焦虑；术后第2、4个月症状的影响因素均为焦虑和辅助治疗，生活质量影响因素均为抑郁、焦虑和辅助治疗。结论肺癌高龄患者术后4个月内生活质量不断提高，大部分症状在不断改善。术后各个阶段症状及生活质量的影响因素略有不同，医护人员及家属应采取有针对性的措施，改善患者的症状及生活质量。%Objective To study on the change of characteristics of symptoms and quality of life and the related factors in elderly patients with lung cancer within 4 months after operation.Methods one hundred and forty -six of lung cancer patients for surgical treatment in our hospital were collected as the research object,Self -Rating Anxiety Scale (SAS),self -rating depression scale (SDS)and the European Co-operative Group Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ -C30)were used to evaluate the anxie-ty,depression,quality of life conditions and symptoms of patients.The data were analyzed using analysis of variance and multiple linear regres-sion analysis means.Results SAS and SDS results showed that SAS and SDS scores decreased within one,two and four months after opera-tion (F =61.215,23.752,P <0.05);questionnaires of EORTC QLQ -C30 showed that physical,role,social,emotional and general health sta-tus scores increased gradually within four months (F =9.195,6.868,10.610,16.470,6.472,P <0.05);fatigue,pain,difficulty breathing,loss of appetite,insomnia scores decreased (F =9.541,40.216,5.739,10.481,7.384,P <0.05);There were no statistical differences in cognition, nausea or vomiting,diarrhea,constipation,economic hardship (P >0.05).Multiple linear regression analysis showed that influential factors of symptoms were anxiety factors,smoking status and surgical methods (P <0.05),quality of life were smoking status,depression and anxiety within one month after operation (P <0.05);However,within two and four months factors of symptoms were anxiety and adjuvant treatment, quality of life were depression,anxiety,and adjuvant therapy (P <0.05).Conclusions The quality of life and most of the symptoms of elder-ly patients with lung cancer increased gradually within four months.Influential factors of symptoms and quality of life varies at each stage after operation,health care workers and family members should take targeted measures to improve the patient's symptoms and quality of life.