肺癌恶性胸腔积液置管引流患者生活质量调查及影响因素分析

苗凯玲 李春燕 侯惠如

[摘要] 目的 调查肺癌恶性胸腔积液置管引流患者的生活质量并探讨影响其生活质量的主要因素。 方法 选择2017年1～10月解放军总医院呼吸科收治的64例肺癌恶性胸腔积液置管引流患者为观察组，同时选择66例晚期肺癌未出现恶性胸腔积液患者为对照组。采用肺癌生活质量量表（FACT-L 4.0）评估患者生活质量，采用多因素分析对可能影响肺癌恶性胸腔积液置管引流患者生活质量的因素进行分析。 结果 观察组患者FACT-L量表生理状况、功能状况、肺癌特异模块及生活质量总分低于对照组，差异有统计学意义（P < 0.05）。病理分型、体力活动状态（PS）评分、胸腔置管引流次数、文化程度、收入来源、知情状态是肺癌恶性胸腔积液置管引流患者生活质量的影响因素（P < 0.05）。PS评分、知情状态、胸腔置管引流次数是肺癌恶性胸腔积液置管引流患者生活质量的独立影响因素（P < 0.05）。 结论 肺癌恶性胸腔积液置管引流患者生活质量差，PS评分、知情状态、胸腔置管引流次数是其独立影响因素。

[关键词] 肺癌；胸腔积液；引流；生活质量

[中图分类号] R734.2 [文献标识码] A [文章编号] 1673-7210（2018）08（a）-0064-05

[Abstract] Objective To investigate the quality of life （QOL） of lung cancer malignant pleural effusion patients with catheter drainage and explore the main factors affecting their quality of life. Methods From January to October in 2017， in Department of Respiratory Medicine， Chinese PLA General Hospital， 64 cases of lung cancer with malignant pleural effusion were selected as observation group， and at the same time， 66 cases of advanced lung cancer without malignant pleural effusion were selected as control group， the quality of life of patients were evaluated by using lung cancer quality of life scale （Fact-l 4.0）. Multivariate analysis was used to analyze the factors that may affect the life quality of patients with malignant pleural effusion and drainage of lung cancer. Results The Physical well-being， functional well-being， lung cancer subscale and FACT-L total score in the observation group were significantly lower than those in the control group， the differences were statistically significant （P < 0.05）. Pathologic typing， PS score， number of indwelling pleural catheters， education level， source of income， informed status were the factors of quality of life in lung cancer malignant pleural effusion patients with catheter drainage （P < 0.05）. PS score， informed status， and number of indwelling pleural catheters were independent factors affecting the quality of life of lung cancer malignant pleural effusion patients with catheter drainage （P < 0.05）. Conclusion The quality of life of lung cancer malignant pleural effusion patients with catheter drainage is poor， PS score， informed state and number of indwelling pleural catheters are independent influencing factors.

[Key words] Lung cancer； Pleural effusion； Drainage； Quality of life

肺癌是臨床最常见的恶性肿瘤之一，其发病率和死亡率居各种肿瘤的首位[1]。恶性胸腔积液（malignant pleural effusion，MPE）指原发于胸膜或其他部位的恶性肿瘤转移至胸膜所致的胸膜腔积液[2]，以肺癌、乳腺癌、淋巴瘤最常见，易引起相关脏器压迫症状，导致胸闷、气促、呼吸困难等，严重影响患者生活质量[3]。本研究旨在调查肺癌MPE置管引流患者生活质量，探讨其影响因素，为改善其生活质量提供依据。