肝癌病人生存质量调查

调查肝癌患者生存质量变化情况和影响因素。方法：采用消化病生存质量指数（ＧＬＱＩ指数）前瞻性地测定３６例外科肝癌病人在接受手术治疗前以及术后一年内不同时期的生存质量值。结果：肝癌病人均有不同程度的生存质量减低。手术前平均ＧＬＱＩ生存质量指数为１０６分，各组分值相近。术后２周和５周所有患者ＧＬＱＩ指数均明显降低，分别为７９２和８２分（Ｐ＜００１），其中老年组较非老年组、肝功能ＣｈｉｌｄＢ级患者较ＣｈｉｌｄＡ级患者下降更为明显（Ｐ＜００５）。术后第１０周和第１６周生存质量逐渐恢复，分别上升为９８和１０１分（Ｐ＞００５），仍以老年组和ＣｌｉｌｄＢ级患者显得较低，但统计学处理已无显著性差异（Ｐ＞００５）。生存半年以上的患者生存质量可超过手术前水平，肿瘤复发病人预后较差，生存质量持续下降（Ｐ＜００１）。联合肝段切除和半肝切除较肝段切除在术后２～５周对患者生存质量的影响更为明显（Ｐ＜００５）。结论：生存质量测定可有效地用于肝癌患者的健康和疗效评估。肿瘤复发、肝功能障碍以及早期手术创伤是影响生存质量的主要因素

Ouality of Life in Patients with Liver Cancer

Objective: This prospective study was to evaluate the quality of life in patients with liver cancer.Methods: The quality of life were measured in 36 consecutive patients by using Gastrointestinal Quality of Life Index(GLQI)regularly for 12 months,starting with a preoperative measurement. Results: 2 weeks and 5 weeks after the operations the mean preoperative GLQI scores was 106,the scores on the GLQI was then reduced to 86 and 96, respectively ( P <0 05) Thereafter the quality of life recovered gradually, 10 and 16 weeks after the operations the GLQI scores reached to 96 and 98 respectively. For the patients who survived more than 6 months, the GLQI scores was restored and higher than before the operation.After the 5th postoperative week,the major hepatectomy (lobectomies and combined segmentectomies)seemed to reduce the GLQI scores more seriously than the minor hepatectomy(simple segmentectomy) ( P <0 05) Patients free from cancer and with Child class A disease had a higher GLQI scores than the Patients with Child class B disease( P <0 05). Conclusion: The assessment of Quality of Life is meaningful for the patients with liver cancer.Tumor recurrence,poor liver function and major operation are the most important factors to change the quality of life.