癌因性疲乏对原发性肝癌患者不同治疗方式近期生命质量的影响

目的:调查原发性肝癌患者不同治疗方式4个时间点(术后2个月以内)生命质量与癌因性疲乏状况,并分析癌因性疲乏对生命质量的影响。方法:采取方便抽样法选择明确诊断为原发性肝癌行手术切除的患者54例(手术组),经皮射频消融治疗的患者63例(PRFA组),采用肝癌患者生命质量测定量表及Piper疲乏修正量表对两组患者术前,术后第5 d、第4周、第8周4个时间点进行生命质量各指标及癌因性疲乏各指标的测量。结果:与手术组相比,PRFA组患者在认知疲乏、行为疲乏及癌因性疲乏术后第4周恢复最好,明显优于手术组(P<0.05)。两组患者术后第8周时在癌因性疲乏总分及各维度得分上均无统计学意义(P>0.05),并且所有患者癌因性疲乏总分及各维度得分均低于治疗前。经多元逐步回归分析发现,年龄、睡眠、收入、文化、手术切除、疲乏状况总分及行为疲乏对于生命质量总分及4个维度有影响(P<0.05)。结论:PRFA组患者近期的癌因性疲乏较手术组更使患者受益,但两种治疗方式均可明显地降低癌因性疲乏。两组患者的癌因性疲乏与生命质量在多个维度上呈显著负相关,疲乏与生命质量两者相互影响,应采取干预措施提高肝癌患者的生命质量。

Impact of cancer-related fatigue in primary hepatocellular carcinoma treated by different ways on the recent quality of life

Objective：To investigate the status of cancer-related fatigue and quality of life in primary liver cancer patients receiving hepatectomy or percutaneous radiofrequency ablation,and analyze the influence of cancer-related fatigue on quality of life at four time-point（within two months） after different therapies.Methods： QOL-LC（quality of life with liver cancer） and RPFS（revised piper fatigue scale） was used to study the quality of life in 117 PLC patients before operation and 5 days,4 weeks and 8 weeks after operation,in which 54 patients underwent hepatectomy（hepatectomy group）,and 63 patients underwent percutaneous radiofrequency ablation（PRFA group）.Results： The score of RFA group in cognitive fatigue,behavior fatigue and RPFS was lower than that of hepatectomy group 4 weeks after operation（P0.05）.The scores of two group in overall scoers were not significantly different 8 weeks after operation（P0.05）.The scores of two group in all parts 8 weeks afetr operation were lower than that before operation.Liner regression analysis showed that age,sleeping,income,culture,hepatectomy,the scores of RPFS and behavioral had significant effects on 4 subscales scores of QOL-LC（（P0.05）.Conclusion： The RPFS of PLC patients was more significantly improved by PRFA than hepatectomy.The RPFS of PLC patients could be significantly improved by hepatectomy and PRFA.Age,sleeping,income,culture,hepatectomy,the scores of RPFS and behavioral are the factors affecting quality of life in PLC patients.