口腔颌面部恶性肿瘤患者术后生存质量影响因素分析

Influencing factors for postoperative quality of life in patients with oral and maxillofacial malignancies

摘要:

目的：探讨口腔颌面部恶性肿瘤患者术后生存质量的影响因素。方法：选取国内某三甲口腔专科医院2016年1月至2018年3月接受手术治疗的90名口腔颌面部恶性肿瘤患者为研究对象，通过现场访谈、问卷调查及数据测量等方式采集人口学、社会心理学及医疗护理方面共29个因素，利用头颈部肿瘤患者生活质量测定量表第4版生活质量问卷评估患者的术后生存质量。再通过单因素及多因素分析，确定影响术后生存质量的独立影响因素。结果：单因素和多因素分析结果显示，有无下颌骨节段切除（OR=50.897，P=0.035，95%CI=1.319～1 964.684）、中文版安德森吞咽困难量表评分（OR=1.260，P=0.002，95%CI=1.086～1.462）、社会支持好（OR=677.074，P=0.045，95%CI=1.166～381 787.087）、微型营养评估记录表评分（OR=28.788，P=0.041，95%CI=1.151～719.778）是口腔颌面部恶性肿瘤患者术后生存质量的独立影响因素。结论：保留口腔颌面部恶性肿瘤患者下颌骨连续性、重建吞咽功能、改善营养状况以及社会支持是提高术后生存质量的有效途径。

Abstract:

Objective：To investigate the influencing factors for postoperative quality of life（QOL） in patients with oral and maxillofa－cial malignancies（OMMs）. Methods：A total of 90 patients with oral and maxillofacial malignancies（OMMs） who underwent surgical treatment in a grade A tertiary stomatological hospital in China from January 2016 to March 2018 were selected as subjects. Twenty-nine factors of demography，social psychology，and medical care were collected by on-site interviews，questionnaires，and data mea－surements. The postoperative QOL of patients was evaluated using Functional Assessment of Cancer Therapy-Head and Neck-V4 [FACT-H&N（V4）]. Independent factors for postoperative QOL were analyzed by univariate and multivariate analyses. Results：The univariate and multivariate analyses showed that segmental resection of lower jaw bone（OR=50.897，95%CI=1.319 to 1 964.684，P=0.035），M.D. Anderson Dysphagia Inventory（MDADI） score（OR=1.260，95%CI＝1.086 to 1.462，P=0.002），good social support（OR=677.074，95%CI＝1.166 to 381 787.087，P=0.045） and mini nutritional assessment（MNA） score（OR=28.788，95%CI＝1.151 to 719.778，P=0.041） were independent influencing factors for the QOL of patients with OMMs. Conclusion：It is an effective way to improve the postoperative QOL of patients with OMMs by retaining the continuity of lower jaw bone，reconstructing swallowing func－tion and improving nutritional status and social support.