摘要
目的探讨鼻咽癌放疗后长期无瘤生存者生存质量并提出相关护理对策。方法以EORTCQLQ-C30V3.0与QLQ-H&N量表外加听力问题作为单一条目测定30例经根治性放射治疗后长期无瘤生存者生存质量。用逐步回归法,以总体健康状况为因变量,分别以症状领域、功能领域、临床因素为自变量进行多元线性回归分析。结果平均随访期78个月(59～103个月)。总体健康状况标准分66.94±28.41。标准分均数前8位的症状领域依次为体重减轻、口干、营养补充、张口困难、牙齿问题、唾液黏稠、经济困难、听力问题。功能领域标准分得分依次为角色功能、躯体功能、社会功能、情绪功能、认知功能。入选的自变量有唾液黏稠(P=0.07;标准回归系数β=-0.303;95%可信区间CI=-0.59～0.03)、张口困难(P=0.01;β=-0.53;95%CI=-0.73～-0.12)、认知功能(P=0.02;β=0.41;95%CI=0.07～0.86)、年龄(P=0.04;β=-0.36;95%CI=-1.89～-0.06)、放射性低位脑神经损伤(P=0.05;β=-0.33;95%CI=-55.34～0.46)。结论鼻咽癌放疗后长期无瘤生存者总体生存质量尚可,其独立影响因素中,唾液黏稠及张口困难的严重程度、年龄大小、放射性低位脑神经损伤的有无与之负相关,认知功能则与之正相关。应重点针对这些不良反应采取相应的护理对策,加强健康教育、定期随访、心理护理、康复护理、社会支持。
Objective This study was designed to evaluate the quality of life（QOL） of disease-freely survival NPC patients after treatment,and to investigate the factors correlated with their QOL.Methods 30 long-term disease-free survival nasopharyngeal carcinoma（NPC） patients after radiotherapy were asked to complete Chinese versions of EORTC QLQ-C30 questionnaire and the QLQ-HN module,adding with one item for hearing.Results The median survival time was 3.6 years（ranged 2.4-4.6 years）.General global health status（GHS） was calculated as 66.94±28.41.Multiple stepwise regression analysis showed that sticky saliva（P = 0.07;standardized coefficient[β]= -0.303;95% confidence interval[CI]= -0.59 ～ 0.03）,opening mouth（P =0.01;β = -0.53;95%CI = -0.73 ～ -0.12）,cognitive functioning（P = 0.02;β = 0.41;95% CI = 0.07 ～ 0.86）,age（P = 0.04;β = -0.36;95% CI = -1.89 ～ -0.06） and radiation-induced lower cranial neuropathy（RILCNP）（P =0.05;β = -0.33;95%CI = -55.34 ～0.46） were independent factors affecting GHS.Conclusion QOL of long-term disease-free survival NPC patients are acceptable.Sticky saliva,opening mouth,age,RILCNP are negative correlation with GHS,while cognitive functioning is inverse.Nursing strategies should focus on these adverses.
出处
《中国现代药物应用》
2010年第18期193-195,共3页
Chinese Journal of Modern Drug Application
关键词
鼻咽肿瘤
放射疗法
生存质量
辐射损伤
护理对策
Nasopharyngeal neoplasms
Radiotherapy
Quality of life
Radiation injuries
Nursing strategies
