影响骨肉瘤治疗后生活质量的相关因素分析

Factors impacting quality of life after treatment of osteosarcoma

摘要:

[目的] 探讨影响骨肉瘤患者治疗后生活质量的相关影响因素及干预措施。[方法] 回顾性分析 2020 年 3 月—2022 年 3 月本院收治的 80 例骨肉瘤患者临床资料，术后 3 个月依据癌症患者生命质量测定量表 QLQ-C30 评分分为生活质量好与生活质量差两组，采用单因素比较和逻辑回归分析影响骨肉瘤患者生活质量的相关因素。[结果]80 例骨肉瘤患者术后 3 个月均存活，生存率为 100%（80/80），将 70 分以下的 23 例患者划为生活质量差组，占 28.8%；≥70 分的 57 例患者划为生活质量好组，占 71.2%。单因素比较显示生活质量差组的治疗前营养状态、病理性骨折、手术方式为截肢、有远处转移的比率、治疗前睡眠质量、家庭功能的应对方式均显著差于生活质量好组（P＜0.05）。二元多因素逻辑分析显示，营养状态差（OR=6.667, 95% CI 2.241~19.830, P＜0.001)、临床分期 III 期 （OR=3.240, 95% CI 1.058~9.920, P＜0.001)、病理性骨折 （OR=7.736, 95% CI 2.621~ 22.836, P＜0.001)、截肢手术（OR=6.505, 95% CI 2.243~18.868, P＜0.001)、远处转移（OR=20.611, 95% CI 5.523~76.913, P＜0.001)、 睡眠质量差（OR=6.346, 95% CI 2.203~18.278, P＜0.001)、家庭功能低水平（OR=5.436, 95% CI 1.893~15.608, P=0.002）、消积应对 （OR=6.682, 95% CI 2.206~20.370, P=0.002）为骨肉瘤患者生活质量差的独立危险因素。[结论]营养状态差、临床Ⅲ期、病理性骨折、截肢术等为影响骨肉瘤患者生活质量的危险因素，临床需针对性干预，以提高骨肉瘤患者生活质量。

Abstract:

[Objective] To explore the factors affecting the quality of life of patients with osteosarcoma after treatment. [Methods] A total of 80 patients who received treatments for osteosarcoma in our hospital from March 2020 to March 2022 were retrospectively analyzed. Three months after surgery, the patients were divided into good quality of life and poor quality of life group according to QLQ-C30 score of cancer patients' quality of life. Univariate comparison and logistic regression analysis were used to analyze the factors impacting quality of life of patients with osteosarcoma. [Results] All the 80 patients with osteosarcoma survived 3 months after treatments, with the survival rate of 100% (80/80). Of them, 23 patients with QLQ-C30 scores below 70 were classified as poor quality of life group, accounting for 28.8%, while the remaining 57 patients with scores ≥70 were classified as good quality of life group, accounting for 71.2%. As results of the univariate comparison, the poor group proved significantly inferior to the good group in terms of the nutritional status before treatment, pathological fracture, surgical mode of amputation, distant metastasis, sleep quality before treatment, family function and coping attitude (P＜0.05). Regarding binary multifactor logistic analysis, the poor nutritional status (OR=6.667, 95% CI 2.241~19.830, P＜0.001), clinical stage III (OR= 3.240, 95% CI 1.058~9.920, P＜0.001), pathological fracture (OR=7.736, 95% CI 2.621~22.836, P＜0.001), amputation (OR=6.505, 95% CI 2.243~18.868, P＜0.001), distant metastasis (OR=20.611, 95% CI 5.523~76.913, P＜0.001), poor sleep quality (OR=6.346, 95%CI 2.203~ 18.278, P＜0.001), low level of family function (OR=5.436, 95%CI 1.893-15.608, P=0.002), improper coping alttitude (OR=6.682, 95% CI 2.206~20.370, P=0.002) were independent risk factors for poor quality of life in patients with osteosarcoma. [Conclusion] Poor nutritional status, clinical stage III, pathological fracture and amputation are risk factors affecting the quality of life of patients with osteosarcoma. Targeted intervention is needed to improve the quality of life of patients with osteosarcoma.