肺癌惡性胸腔積液置管引流患者生活質量調查及影響因素分析

苗凱玲 李春燕 侯惠如

[摘要] 目的 調查肺癌惡性胸腔積液置管引流患者的生活質量并探討影響其生活質量的主要因素。 方法 選擇2017年1～10月解放軍總醫院呼吸科收治的64例肺癌惡性胸腔積液置管引流患者為觀察組，同時選擇66例晚期肺癌未出現惡性胸腔積液患者為對照組。采用肺癌生活質量量表（FACT-L 4.0）評估患者生活質量，采用多因素分析對可能影響肺癌惡性胸腔積液置管引流患者生活質量的因素進行分析。 結果 觀察組患者FACT-L量表生理狀況、功能狀況、肺癌特異模塊及生活質量總分低于對照組，差異有統計學意義（P < 0.05）。病理分型、體力活動狀態（PS）評分、胸腔置管引流次數、文化程度、收入來源、知情狀態是肺癌惡性胸腔積液置管引流患者生活質量的影響因素（P < 0.05）。PS評分、知情狀態、胸腔置管引流次數是肺癌惡性胸腔積液置管引流患者生活質量的獨立影響因素（P < 0.05）。 結論 肺癌惡性胸腔積液置管引流患者生活質量差，PS評分、知情狀態、胸腔置管引流次數是其獨立影響因素。

[關鍵詞] 肺癌；胸腔積液；引流；生活質量

[中圖分類號] R734.2 [文獻標識碼] A [文章編號] 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

肺癌是臨床最常見的惡性腫瘤之一，其發病率和死亡率居各種腫瘤的首位[1]。惡性胸腔積液（malignant pleural effusion，MPE）指原發于胸膜或其他部位的惡性腫瘤轉移至胸膜所致的胸膜腔積液[2]，以肺癌、乳腺癌、淋巴瘤最常見，易引起相關臟器壓迫癥狀，導致胸悶、氣促、呼吸困難等，嚴重影響患者生活質量[3]。本研究旨在調查肺癌MPE置管引流患者生活質量，探討其影響因素，為改善其生活質量提供依據。