口腔颌面部肿瘤患者围术期症状群与生活质量相关性研究

doi:10.19438/j.cjoms.2024.05.006

摘要/Abstract

摘要： 目的: 调查口腔颌面部肿瘤皮瓣移植患者围术期症状群和生活质量状况,分析两者的相关性。方法: 对2022年12月—2023年12月就诊于上海交通大学医学院附属第九人民医院的211例口腔颌面部肿瘤皮瓣移植患者进行便利抽样,采用安德森症状评估量表-头颈部量表和华盛顿大学生存质量评估问卷量表第四版,在皮瓣移植术前、术后7天和术后1个月对患者进行纵向调查。采用SPSS 26.0软件包对数据进行统计学分析。结果: 口腔颌面部肿瘤皮瓣移植患者在围术期 3个时间点得出5个症状群,神经系统症状群在术前和术后1个月被提取出,胃肠道症状群只在术后7天被提取出,吞咽-发音障碍症状群、疾病特异性症状群以及疲乏-睡眠-情绪症状群持续存在于整个围术期。3个时间点生活质量总分比较有统计学差异（P<0.001）。患者生活质量总分、社会情绪领域得分与5个症状群严重程度均呈负相关（P<0.05）,其中,手术前吞咽-发音障碍症状群和疲乏-睡眠-情绪症状群对患者生活质量有显著影响（R²=0.613,P<0.05）;术后7天吞咽-发音障碍症状群、疾病特异性症状群和疲乏-睡眠-情绪症状群对患者生活质量的影响有统计学差异（R²=0.614,P<0.05）;术后1个月吞咽-发音障碍症状群、疲乏-睡眠-情绪症状群和神经系统症状群对患者生活质量的影响有统计学差异（R²=0.577,P<0.05）。结论: 口腔颌面部肿瘤皮瓣移植患者围术期存在多个稳定的症状群,症状群越严重,患者生活质量越差。针对症状群采取有效的干预措施,可降低症状群严重程度,提高患者生活质量。

关键词: 口腔颌面部肿瘤, 症状群, 生活质量, 相关性研究

Abstract: PURPOSE: To investigate the perioperative symptom clusters and quality of life status in patients with oral and maxillofacial neoplasms undergoing flap transplantation, and to analyze their correlation. METHODS: A convenience sample of 211 patients with oral and maxillofacial neoplasms undergoing flap transplantation who attended Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from December 2022 to December 2023 were longitudinally surveyed. M.D.Anderson Symptom Inventory-Head & Neck and University of Washington Quality of Life Questionnaire (fourth edition) were used, the patients were investigated longitudinally before, 7 days and 1 month after flap transplantation. SPSS 26.0 software package was used for data analysis. RESULTS: Five symptom clusters were derived from patients with oral and maxillofacial neoplasms undergoing flap transplants at 3 time points during perioperative period. The neurological symptom cluster was extracted before and 1 month after surgery, the gastrointestinal symptom cluster was extracted only 7 days after surgery, and the symptom cluster of dysphagia-dysphonia, disease-specific symptom cluster and fatigue-sleep-mood symptom cluster were extracted persisted throughout the perioperative period. The difference of total quality of life scores at the three time points during the perioperative period was statistically significant(P<0.001). The perioperative severity scores of the five symptom clusters were negatively correlated with their total quality of life scores and socio-emotional domain scores(P<0.05). Before surgery, the dysphagia-dysphonia symptom cluster and the fatigue-sleep-mood symptom cluster had significant effect on patients' quality of life(R²=0.613, P<0.05). Seven days after surgery, the dysphagia-dysphonia symptom cluster,the disease-specific symptom cluster and the fatigue-sleep-mood symptom cluster had significant effect on patients' quality of life(R²=0.614, P<0.05). One month postoperatively, the dysphagia-dysphonia symptom cluster, the neurological symptom cluster and the fatigue-sleep-mood symptom cluster had significant effect on patients' quality of life (R²=0.577, P<0.05). CONCLUSIONS: Patients with oral and maxillofacial neoplasms undergoing flap transplantation had multiple stable symptom clusters perioperatively, the more severe the symptom clusters, the worse the patient's quality of life. Effective interventions for the symptom clusters can reduce the severity of the symptom clusters and improve the patient's quality of life.

Key words: Oral and maxillofacial neoplasms, Symptom cluster, Quality of life, Correlation study

中图分类号:

R739.8

何冉, 侯德强. 口腔颌面部肿瘤患者围术期症状群与生活质量相关性研究[J]. 中国口腔颌面外科杂志, 2024, 22(5): 446-454.

HE Ran, HOU De-qiang. Correlation between perioperative symptom clusters and quality of life in patients with oral and maxillofacial neoplasms[J]. China J Oral Maxillofac Surg, 2024, 22(5): 446-454.

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