中晚期肝癌介入治疗患者的生存质量及预后影响因素分析

目的:探讨中晚期肝癌介入治疗患者的生存质量及预后影响因素。方法:回顾性分析110例中晚期肝癌患者的临床资料,观察患者术后1个月的临床疗效,随访半年、1年和超过2年的患者生存率,记录治疗前后患者生存质量(QOL)评分,采用Logistic回归分析法分析影响预后的相关因素。结果:本组患者半年、1年、2年内累积生存率分别为82.73%、45.45%、21.82%,中位生存时间13个月;术后1个月的治疗总有效率为81.82%(90/110),且治疗后QOL总评分显著高于治疗前(P<0.05)。肝功能Child分级、肿瘤大小、门静脉癌栓、瘤肝比均为影响中晚期肝癌患者介入治疗预后的危险因素,Logistic多因素分析表明肝功能Child分级、肿瘤大小、门静脉癌栓是影响中晚期肝癌患者介入治疗预后的独立危险因素。结论:介入治疗一定程度上能够提高患者的QOL,肝功能Child分级、肿瘤大小、门静脉癌栓、瘤肝比是影响中晚期肝癌介入治疗预后的危险因素,在治疗过程中应密切观察,制定针对性的方案以延长患者生存时间。

Analysis of QOL and prognostic influencing factors of patients with middle and advanced hepatic cancer treated by interventional treatment

Objective:To explore the quality of life (QOL)and prognostic influencing factors of patients with middle and ad-vanced hepatic cancer treated by interventional treatment.Methods:The clinical data of 1 10 patients with middle and advanced hepatic cancer were retrospectively analyzed.Clinical efficacy 1 month after operation,survival rates after 6-month,1 -and 2-year follow up were observed,QOL scores before and after treatment were recorded,and Logistic regression analysis was used to analyze the influencing fac-tors for prognosis.Results:The 6-month,1 -and 2-year accumulated survival rates were 82.73%,45.45% and 21 .82%,and the median survival time was 13 months.The total therapeutic rate (RR)1 month after operation was 81 .82% (90 /1 10),and QOL score was markedly higher after treatment than treatment before (P <0.05 ).Liver function Child class,tumor size,portal vein tumor thrombus (PVTT),and ratio of tumor and liver were the risk factors for the prognosis,in which liver function Child class,tumor size,and PVTT were proved to be independent influencing factors for prognosis of patients with middle and advanced hepatic cancer treated by interven-tional treatment,according to Logistic multivariate analysis.Conclusion:Interventional treatment can increase patients’QOL to some extent,and liver function Child class,tumor size,PVTT,and ratio of tumor and liver are the risk factors for the prognosis patients with middle and advanced hepatic cancer treated by interventional treatment.During treatment,the above factors should be closely observed and specific protocols should be established to prolong patients’survival time.