摘要
目的:仅以发病率、患病率、病死率作为反映临床治疗和卫生预防措施的效果存在一定的局限性,人们越来越多地以生存质量作为终点指标。调查及评价血液肿瘤患者造血干细胞移植后的生存质量及其影响因素。方法:选择于2001-09/2006-06在广西医科大学第一附属医院血液科进行造血干细胞移植的、对汉语语言文字有正确理解能力的、年龄在18周岁以上的42名患者,男34例,女8例,移植前经骨髓病理学确诊为恶性血液病,移植后骨髓及外周血检验未发现异常细胞、染色体分析及基因检查均正常。征得患者同意后,采用QLQ-C30量表问卷的方式对42例患者的生存质量进行调查,QLQ-C30质量问卷量表(V3.0)由3个子量表及6个单测项目共30个问题组成,反映患者的总体健康状况、躯体功能、角色功能、情感功能、认知功能和社会功能,以及疲乏、恶心呕吐、疼痛、呼吸困难、失眠、食欲减退、便秘、腹泻、经济困难症状的情况。功能性评分和总体健康状况评分越高表明生存质量越好,症状类评分越高则意味着症状越严重。并选取30名健康普通成人各维度得分为对照。采用相关分析及多元回归模型分析影响患者生存质量的因素。结果:72名受试者均进入结果分析。42例患者总体健康状况中等,与普通人群相比,躯体功能和认知功能恢复较好(P>0.05),其他功能状态恢复较差,社会功能中位得分最低(P<0.01),症状分级中疲乏症状最明显(P=0.000),64.3%存在经济困难(P=0.000)。回归分析显示,原发病、血型相合度、HLA相合度、婚姻、家庭月收入、因病借钱及移植后费用与生存质量功能状态相关,并影响功能维度得分(P<0.05)。而年龄、职业、移植类型和预处理方案等因素不影响功能维度得分。结论:移植后血液病患者生存质量满意度较好,躯体功能恢复好,疲乏常见,经济情况是生存质量的主要影响因素。
ALM： There exist certain limitation in the effect of clinical treatment and hygiene precautionary measure only with incidence, morbidity and mortality. Now, quality of life （QOL） has been regarded as the terminal index. In this study, the QOL of patients with haematological tumor who underwent hematopoietic stem cell transplantation （HSCT） was investigated and assessed. METHODS： Forty-two adult patients including 34 males and 8 females, who received HSCT in the Department of Hematology of the First Affiliated Hospital of Gangxi Medical University from September 2001 to June 2006 and could correctly understand the language and characters, were selected. They were diagnosed with hematological tumor before HSCT; no abnormal cells were found after transplantation, and the chromosome analysis and gene examination were normal. After the informed consent was obtained from the patients, their QOL was assessed by the QLQ-C30. The QLQ-C30 （V 3.0） was composed of 3 subscales and 6 items, 30 questions. It could reflect the multi-item functions such as general physical condition, somatic function, role function, emotional function, cognitive function and social function, and the symptom such as fatigue, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea, financial difficulties. Higher scores in the functional scales and general condition questions indicated a higher quality of life, while the higher the scores in the symptom scale, the more severe the symptoms were. Meanwhile, 30 healthy adults were selected as controls. The factors for QOL were analyzed with Spearman correlation analysis and multiple linear regression analysis. RESULTS： All 72 subjects were involved in the result analysis. The general physical condition of 42 HSCT survivors was intermediate. They seemed to recover well in the physical and cognitive function compared with normal population （P 〉 0.05）, but worse in the other functions （P 〈 0.01）, especially in social function. Fatigues were significantly found （P = 0.000） and financial difficulties were significantly common （63.4%, P=0.000）. Multiple linear regression analysis indicated that initial diagnosis, blood type compatibility, HLA-matched, marital status, family income and expenses after HSCT were associated significantly with QOL （P 〈 0.05）. Age, occupation, preconditioning regimen and donor type were not statistically significant. CONCLUSION： HSCT survivors are satisfied with their QOL status. Their physical function is recovered well. Fatigues are the common syndromes. The economic burden is the main factor for QOL.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第42期8478-8482,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
广西科学基金项目(桂科基0575076)~~
