吞咽生命质量量表联合纤维内镜下吞咽功能检查技术在鼻咽癌放化疗后吞咽障碍患者中的应用

目的 吞咽生命质量量表(SWAL-QOL)联合纤维内镜下吞咽功能检查技术(FEES)对鼻咽癌放化疗后吞咽障碍患者的吞咽功能进行评估,以了解经放化疗后的鼻咽癌患者的吞咽相关生活质量情况,并拓展二者在临床中的应用。 方法 纳入2019年9月至2020年3月在四川大学华西医院随访的经放化疗治疗的、且存在吞咽障碍的162例鼻咽癌患者为病例组,纳入健康人144例为对照组,两组均填写SWAL-QOL。并对病例组96例患者进行FEES检查,再根据渗漏/误吸量表(PAS)对其吞咽障碍严重程度进行分级。 结果 病例组SWAL-QOL中生活质量量表的总分(124.69±25.57)及吞咽症状维度得分(58.56±9.46)均明显低于对照组,且组间差异有统计学意义(P<0.05);生活质量量表中,除“疲劳”“睡眠”维度外,其余8个维度差异均具有统计学意义(P<0.05)。根据PAS评分显示,无渗漏组22例(22.92%),喉渗漏组60例(62.50%),隐性误吸组14例(14.58%),分组比较:3组病例对比发现,SWAL-QOL总分及“言语交流”“进食恐惧”“疲劳”“睡眠”各维度差异具有统计学意义(P<0.05)。对比无渗漏组与喉渗漏组SWAL-QOL总分、吞咽症状维度评分及生活质量量表各维度的差异均无统计学意义(P>0.05)。对比无渗漏组和隐性误吸组,SWAL-QOL总分、进食时间、言语交流、睡眠各维度的差异有统计学意义(P<0.05),但吞咽症状及其他维度差异无统计学意义(P>0.05)。对比喉渗漏组和隐性误吸组,SWAL-QOL总分,“言语交流”“睡眠”各维度差异有统计学意义(P<0.05),吞咽症状及其他维度差异无统计学意义(P>0.05)。 结论 吞咽障碍对鼻咽癌放化疗后患者生活质量影响是多方面的;SWAL-QOL可联合FEES技术,并结合PAS评分对经放化疗后的鼻咽癌患者的吞咽功能进行评估及吞咽障碍严重程度分级,且PAS分级越高,其SWAL-QOL的评分越低。     

鼻咽癌EGFL7的表达与肿瘤侵袭转移的关系

目的 观察表皮生长因子样结构域7(EGFL7)在鼻咽癌中的表达,并了解其与微血管密度(MVD)、淋巴管密度(LVD)的相关性,探讨其与鼻咽癌侵袭转移的关系及其可能的机制.方法 采用免疫组化法检测40例鼻咽癌组织(实验组)及20例鼻咽炎(对照组)中的EGFL7的表达;用CD31抗体及D2-40抗体分别检测实验组及对照组的MVD及LVD,并分析EGFL7的表达与肿瘤分级及MVD、LVD三者的相关性.结果 实验组与对照组均有EGFL7的表达,但实验组中EGFL7高表达率高于对照组(P<0.05);实验组中EGFL7的表达与MVD呈正相关,但与LVD相关性不明显;实验组中有淋巴结转移的LVD明显高于无淋巴结转移的(P<0.05);实验组中EGFL7的表达与患者性别、年龄、EB病毒抗体无相关性(P>0.05),与临床分期及有无淋巴结转移有关(P<0.05).结论 EGFL7并不像VEGF家族对血管、淋巴管均有双重作用,它仅表达于血管内皮细胞及鼻咽癌细胞中.EGFL7与鼻咽癌的生长和侵袭转移关系密切,它可能成为反映鼻咽癌转移及预后的标志物之一.     

糠酸莫米松鼻喷剂联合玉屏风颗粒可提高儿童腺样体肥大疗效

目的 探讨糠酸莫米松鼻喷剂联合玉屏风颗粒治疗儿童腺样体肥大的疗效。 方法 采用前瞻性随机对照研究,对90例4~10岁腺样体肥大儿童单用糠酸莫米松鼻喷剂或联合玉屏风颗粒口服治疗8周,对比治疗前后患儿临床症状积分,内镜下观察腺样体变化,记录上呼吸道感染次数。 结果 对照组(鼻喷激素)临床症状总积分减少19.5%,鼻咽阻塞程度从82.2%下降到73.6%(P<0.01),上呼吸道感染次数大于1次者占44.19%;试验组(联合用药)临床症状总积分减少31.7%,鼻咽阻塞程度从85.4%下降到71.4%(P<0.01),上呼吸道感染次数>1次者占16.67%。 结论 糠酸莫米松鼻喷剂治疗儿童腺样体肥大有效,联合玉屏风颗粒可进一步提高疗效,并可减少儿童上呼吸道感染的发生率。     

耳后药物注射治疗突发性聋32例

目的 观察耳后注射糖皮质激素治疗突发性聋的疗效.方法 65例突聋患者分为耳后注射组(32例)和鼓室给药组(33例),除常规治疗外,两组分别经耳后注射和鼓膜穿刺给予地塞米松0.5 mg,1次/3 d,疗程14 d.结果 耳后注射组和鼓室给药组听力改善分别为(13.2±8.6)dB和(14.6±11.1)dB,两组治疗前后比较差异均有统计学意义(P<0.05),组间比较差异无统计学意义(P>0.05),不良反应试验组低于对照组(P<0.05).结论 突聋患者耳后局部注射糖皮质激素效果明显、操作简单、不良反应低,可作为鼓室给药有禁忌时的备选疗法.     

Ex-PRESS引流器植入术治疗青光眼的临床观察

目的 研究Ex-PRESS引流器植入术对青光眼患者眼内压和角膜内皮细胞数的影响。 方法 选取收治的62例青光眼患者,对照组患者31例(33眼),行复合式小梁切除术;研究组患者31例(35眼),行Ex-PRESS引流器植入术。 结果 研究组患者手术总成功率(88.57%)较对照组(66.67%),差异有统计学意义(P<0.05);术后6个月,研究组患者视力改善情况优于对照组,且研究组患者视力提高比例(85.71%)高于对照组(60.61%),差异具有统计学意义(P<0.05);与术前相比,两组患者术后眼压均下降(P<0.05),且术后1、3、6个月研究组患者的眼压低于对照组(P<0.05);术后1、3、6个月两组患者的角膜内皮细胞数较术前均下降(P<0.05),两组患者间角膜内皮细胞数比较差异无统计学意义(P>0.05);研究组患者并发症发生率(17.14%)低于对照组(45.45%),差异有统计学意义(P<0.05)。 结论 Ex-PRESS引流器植入术对青光眼患者的角膜内皮细胞数的影响与复合式小梁切除术相当,远期降眼压效果优于小梁切除术。     

咽喉反流伴阻塞性睡眠呼吸暂停低通气综合征患者的治疗及其咽喉反流体征评分、症状指数特点

目的 分析咽喉反流病(LPRD)伴阻塞性睡眠呼吸暂停综合征(OSAS)患者的咽喉反流体征评分(RFS)和咽喉反流症状指数(RSI)特点,探讨临床治疗效果。 方法 抽取100例LPRD患者,将其中合并有OSAS的患者作为观察组(n=39),其余作为对照组(n=61),观察两组RFS、RSI及呼吸暂停低通气指数(AHI)、血氧饱和度(SaO₂)、反流总数、总反流时间;比较治疗2个月后RSI、RFS评分。 结果 观察组RFS和RSI评分总分显著高于对照组,RFS体征差异均有统计学意义(P<0.05),咽喉反流伴OSAS患者声门下水肿、喉室消失、杓会厌襞红斑/充血、喉黏膜水肿、后联合肥厚或肿胀评分显著高于单纯的咽喉反流患者(P<0.05),RSI评分中咽喉反流伴OSAS患者呼吸困难、烧心胸痛胃酸反流评分显著高于单纯的咽喉反流患者(P<0.05);治疗后,观察组RSI评分总分高于对照组(P均<0.05),对照组在呼吸困难、烧心胸痛胃酸反流方面明显优于观察组(P<0.05)。治疗前后,两组AHI、SaO₂、反流总数比较均差异有统计学意义(P<0.05)。治疗后,观察组AHI、SaO₂均明显改善,与治疗前比较差异有统计学意义(P<0.05),两组反流总数、总反流时间改善显著,对照组优于观察组(P<0.05)。 结论 伴OSAS会加重LPRD患者咽喉反流相关症状,可能是LPRD患者治疗效果和症状改善较差的原因。     

鼻腔扩容术对慢性鼻-鼻窦炎伴睡眠呼吸暂停

目的 探讨鼻腔扩容术对慢性鼻-鼻窦炎伴睡眠呼吸暂停低通气综合征(OSAHS)成年患者睡眠质量的影响。 方法 选取80例慢性鼻-鼻窦炎伴睡眠呼吸暂停低通气综合征(OSAHS)成年患者,治疗之前对所有患者进行鼻阻力测量鼻功能检查、耳鼻喉专科查体以及多导睡眠监测,并填写Epworth嗜睡量表(ESS)以及鼻腔鼻窦结局测量-20(SNOT-20)量表。术后随访,第3个月时对所有患者复查以上指标。 结果 术前与术后3个月相比,所有患者SNOT-20量表总分明显降低(P<0.05);ESS值明显降低(P<0.05);鼻腔总阻力明显下降(P<0.05)。 结论 SNOT-20量表与多导睡眠联合监测对鼻腔扩容术的疗效评价更为准确,应用鼻腔扩容术可以显著改善慢性鼻-鼻窦炎伴睡眠呼吸暂停低通气综合征成年患者睡眠质量。     

142例喉癌术后患者整体睡眠质量状况调查分析

目的 了解喉癌术后患者整体睡眠质量状况。 方法 以2015年5月至12月就诊于青岛大学附属医院耳鼻咽喉头颈外科门诊复查的142例喉癌术后患者(实验组)和48例查体健康者(对照组)为研究对象,采用匹兹堡睡眠质量指数(PSQI)、睡眠状况自评量表(SRSS)对其进行问卷调查,调查结果量化评分,并进行统计学分析。 结果 实验组与对照组PSQI总分分别为(7.20±3.84)、(4.42±1.61)分,二者比较差异有统计学意义(P<0.001)。实验组与对照组SRSS总分分别为(24.92±5.80)、(18.27±3.39)分,二者比较差异有统计学意义(P<0.001)。放化疗者与非放化疗者PSQI总分分别为(7.65±4.39)、(6.92±3.45)分,二者比较差异无统计学意义(P=0.295);放化疗与非放化疗者SRSS总分分别为(25.56±6.11)、(24.52±5.60)分,二者比较差异无统计学意义(P=0.297)。喉部分切除术后拔管者、喉部分切除术后未拔管者、喉全切除术后者PSQI总分分别为(6.90±3.33)、(8.80±5.44)、(7.20±3.98)分,三者比较差异无统计学意义(P=0.215);三者SRSS总分分别为(24.05±4.92)、(27.80±8.00)、(25.40±6.10)分,三者比较差异无统计学意义(P=0.055)。142例喉癌患者中92例存在不同程度的疼痛不适,占64.79%;135例有口腔干燥、次数不等的夜间如厕情况,占95.07%;112例有醒来后再次入睡困难的情况,占78.87%。 结论 喉癌患者术后整体睡眠质量较差,导致睡眠质量低下的主要原因为疾病本身造成的躯体痛苦和心理障碍、治疗导致的后遗症及合并症。     

慢性鼻-鼻窦炎病变程度与支气管哮喘肺功能的相关性

目的 探讨慢性鼻-鼻窦炎(CRS)病变程度与支气管哮喘肺功能的相关性。方法 选择72例慢性鼻-鼻窦炎患者(研究组)和64例非慢性鼻-鼻窦炎患者(对照组),对患者行脉冲振荡法(IOS) 及通气肺功能检查、慢性鼻-鼻窦炎调查问卷,分析CRS病变程度与支气管哮喘肺功能的相关性。结果 ① CRS合并支气管哮喘发生率较高,研究组与对照组相比FEV₁、FEF_25-75差异具有统计学意义(P<0.05);② 研究组中CRS病变程度及范围与FEV₁、FEF_25-75下降有一定的相关性(P<0.05);③ 研究组中CRS病变程度与肺功能相关指标有一定相关性(P<0.05)。结论 CRS病变程度与支气管哮喘肺功能下降有一定的相关性。CRS合并支气管哮喘肺功能呈明显的下降趋势。     

儿童过敏性鼻炎粉尘螨特异性舌下免疫治疗短期疗效评估

目的 评估尘螨过敏的过敏性鼻炎患儿进行舌下免疫治疗的短期疗效。 方法 回顾性分析2019年至2020年就诊于首都儿科研究所附属儿童医院耳鼻咽喉头颈外科,应用粉尘螨舌下特异性免疫治疗满6个月的患儿,分析其治疗前后的视觉模拟量表评分(VAS)、鼻部总症状评分(TNSS)、总用药评分(TMS)、症状药物联合评分(CSMS)。 结果 共纳入50例过敏性鼻炎患儿,平均(7.7±2.7)岁。治疗前VAS、TNSS、TMS、CSMS评分分别为(5.5±1.6)分、(5.5±2.2)分、(3.0±0.1)分、(4.3±0.6)分,治疗后6个月上述评分分别为(2.5±1.4)分、(2.2±1.6)分、(0.6±1.1)分、(1.2±1.2)分,治疗后较治疗前各评分均有下降(P<0.05)。 结论 粉尘螨舌下免疫治疗对于尘螨过敏性鼻炎的患儿短期疗效较好。     

Prospective evaluation of quality of life and nutrition before and after treatment for nasopharyngeal carcinoma

OBJECTIVE: To prospectively assess quality of life in patients undergoing chemoradiation therapy for nasopharyngeal cancer. Concurrent chemoradiotherapy is standard for advanced nasopharyngeal cancer; however, the toxic effects of this treatment are substantial. DESIGN: Prospective evaluation of quality of life and nutritional status before and after treatment for nasopharyngeal carcinoma. Patients and INTERVENTION: A cohort of 14 patients, treated with concurrent chemoradiotherapy for 7 weeks, completed the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire and Head and Neck Module before and 3, 6, 12, and 24 months after treatment. Changes in score were analyzed and correlated with the toxic effect grade. RESULTS: Quality of life issues during the 24 months of follow-up included poorer global health (P = .01), fatigue (P = .01), appetite loss (P<.001), swallowing difficulties (P = .002), sense problems (P = .03), difficulty with social eating (P = .005), dental problems (P = .045), trismus (P = .001), xerostomia (P<.001), sticky saliva (P = .001), cough (P = .02), and feeling ill (P = .03). Pain (P = .004) and emotional functioning (P<.001) significantly improved from the pretreatment rating. The median weight loss was 7 kg, with most weight loss occurring during treatment, despite nutritional support with gastrostomy feeding tubes. One patient still required percutaneous endoscopic gastrostomy feeding at 2 years after treatment. Physician-scored toxic effects correlated poorly with quality-of-life scores. CONCLUSIONS: Quality of life and functional assessment should be important end points in the follow-up of patients with nasopharyngeal cancer who receive chemoradiotherapy. This study supports the need for ongoing support and rehabilitation in a multidisciplinary setting.     

Quality of life for patients following total laryngectomy vs chemoradiation for laryngeal preservation

BACKGROUND: The incorporation of chemotherapy and radiation, either sequentially or concurrently, has been increasingly used for organ preservation in patients with advanced laryngeal cancer. Traditional outcome measures of clinical response such as locoregional control and survival have been similar for patients treated with chemoradiotherapy and those treated with total laryngectomy (TL). The impact of concurrent chemoradiotherapy for laryngeal preservation on the overall quality of life (QOL) of patients has not been clearly evaluated, particularly in direct comparison with TL. OBJECTIVE: To compare the QOL of patients treated with concurrent chemoradiotherapy with those treated with TL. DESIGN: Nonrandomized, retrospective, cross-sectional study. SETTING: Academic tertiary care referral center. METHODS: The study included 42 patients with advanced stage III or IV cancer of the larynx, who were treated with either concurrent chemoradiotherapy or TL with postoperative radiation therapy. Patients had to be without evidence of recurrence and to have completed therapy at least 3 months prior to inclusion in the study. Quality of life was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) in tandem with the head and neck module (EORTC QLQ-H&N35). RESULTS: On the core questionnaire (QLQ-C30), there were no statistically significant differences in the overall QOL score between the 2 groups. Functional subscale analysis revealed a trend for patients in the surgery and radiotherapy group to experience greater difficulties with social functioning (P =.18) relative to the chemoradiation group. On the QLQ-H&N35, surgery patients reported significantly greater difficulties with sensory disturbances (smell and taste, P =.001), use of painkillers (P =.049), and coughing (P =.004). On the other hand, chemoradiation patients reported significantly greater problems with dry mouth (P =.02). CONCLUSIONS: Both chemoradiation and TL affect, albeit differently, the QOL of patients treated for advanced cancer of the larynx. Although these differences can be detected by functional and subscale analysis, the overall QOL scores of both groups seem similar.     

Quality of life in children with velopharyngeal insufficiency

OBJECTIVE: To determine if quality of life (QOL) is affected in children with velopharyngeal insufficiency (VPI). DESIGN: Interview and survey. SETTING: Two university pediatric ambulatory centers. PARTICIPANTS: This population-based sample included 58 children, aged 5 to 17 years, and their parents; 29 of the children were diagnosed as having VPI and 29 were age-matched normal controls. INTERVENTION: Each participant (child and parent) completed 2 questionnaires: the Velopharyngeal Insufficiency Quality of Life (VPIQL), an instrument specifically designed for children with VPI, and the Pediatric Quality of Life Inventory, version 4.0 (PedsQL(4.0)), a standardized generic assessment instrument that systematically assesses the perception of health-related QOL in pediatric patients with chronic health conditions. MAIN OUTCOME MEASURES: The VPIQL questionnaire assessed patients' and parents' perceptions of speech, swallowing, situational and emotional difficulty, activity limitations, and perception of the patient by others. Caregiver impact was also assessed in the parent version of the VPIQL. RESULTS: The patients with VPI and their parents perceived a more statistically significant negative QOL compared with the normal controls and their parents in all domains of the VPIQL and the PedsQL(4.0). The parents of the children with VPI perceived a more negative emotional impact (P = .02), greater speech limitations (P = .05), and fewer swallowing problems (P<.001) compared with their children. CONCLUSIONS: Children with VPI and their parents perceive negative QOL greater than that of normal controls and their parents. Parental proxy may be an adequate substitute in this population.     

Long-term quality of life after total laryngectomy and postoperative radiotherapy versus concurrent chemoradiotherapy for laryngeal preservation

OBJECTIVE: To compare the quality of life (QoL) of patients who underwent total laryngectomy with voice prosthesis insertion and postoperative radiotherapy (PORT) with those receiving concurrent chemoradiation for laryngeal preservation. STUDY DESIGN: Retrospective, cross-sectional study in a tertiary academic center. METHODS: The European Organization for Research and Treatment of Cancer Quality of Life Questionnaires were used to assess long-term QoL in 67 patients treated for laryngeal cancer. RESULTS: The scores of functional scales for physical (P < .000), social (P = .001), and role functioning (P = .043) were more favorable in the chemoradiation group. The global QoL score was higher in the nonsurgical group (P = .016). Surgical patients reported on sleep disturbance (P < .000), dyspnea (P = .001), and pain (P = .003), with a higher scores and greater difficulties with the senses (P < .000), social contact (P = .002) and speech (P = .010). The chemoradiation group reported greater problems with dry mouth (P < .000) and sticky saliva (P = .005). CONCLUSION: We found better long-term QoL scores in patients undergoing concurrent chemoradiation. This appears to be mainly because of better physical functioning, social functioning, and social contact and smaller problems with pain, respiration, speech, the senses, and sleep disturbances.     

Free-flap head and neck reconstruction and quality of life: a 2-year prospective study

Objectives: This prospective study was designed to evaluate quality of life (QOL) after free‐flap head and neck reconstruction. Study Design: Prospective study. Methods: Between January 2004 and December 2005, a total of 95 patients underwent microvascular reconstruction of the head and neck at our Institution (Centre Antoine‐Lacassagne, Nice, France) and were initially included in this study. The European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire and the EORTC Head and Neck Cancer Quality of Life Questionnaire were completed before surgery, and at 6 and 12 months thereafter. Sixty‐five patients completed the questionnaires on at least two of the assessment dates. Predictive factors of Quality of Life (QOL) scores at 6 months were researched among the following: age, sex, comorbidity, radiotherapy, tumor recurrence, tumor stage, and type of surgery. Results: Global QOL remained stable over time. Physical, social, and role functioning deteriorated significantly after treatment. Pain decreased markedly. Social eating, senses, and speech difficulties increased significantly at 6 months, but stabilized between 6 and 12 months. Problems concerning mouth opening and social contact augmented progressively until the 12th postoperative month. Sex, type of surgery, and radiotherapy were the main factors influencing QOL 6 months after treatment. Conclusions: Despite some functional impairments, global QOL was preserved after major head and neck ablative surgery and microvascular free‐flap reconstruction.     

Tornwaldt's cyst formation after concurrent chemoradiotherapy for nasopharyngeal carcinoma

The complications of concurrent chemoradiotherapy for nasopharyngeal carcinoma include dryness of mouth, sensorineural hearing loss, dental caries, trismus, pituitary dysfunction, myelitis, paralysis of cranial nerves IX-XII, massive neck fibrosis and pharyngeal wall necrosis. Tornwaldt's cyst formation after concurrent chemoradiotherapy for nasopharyngeal carcinoma has not been reported previously in the world literature. Tornwaldt's cyst, a persistent pharyngeal bursa, is found in about 3 per cent of the adult population, although the majority of these are asymptomatic. We describe the previously unreported complication of Tornwaldt's cyst formation after concurrent chemoradiotherapy for nasopharyngeal carcinoma.     

局部晚期鼻咽癌新辅助化疗联合同步放化疗

鼻咽癌是我国南部地区最常见恶性肿瘤之一,大部分患者被发现时已处于局部晚期.鼻咽癌对放、化疗比较敏感,过去认为同步放化疗方案是鼻咽癌的标准治疗方式;研究显示新辅助化疗联合同步放化疗对局部晚期鼻咽癌患者的治疗效果更佳.然而调强放疗与传统放疗技术相比,在保证原有治疗效果基础上可进一步降低患者的毒副反应.本文比较在传统放疗与调强放疗技术两种情况下,同步放化疗与同步放化疗联合新辅助化疗的两种方案对局部晚期鼻咽癌患者治疗效果做一综述.     

Quality of life after otoplasty for prominent ears in children

AimProminent ears are a common congenital malformation and are associated with low self-esteem, social isolation and diminished school performance. Our goal was to evaluate the influence of otoplasty on children’s quality of life (QoL).Material and methodsPatients submitted to otoplasty from 2016 to 2018 were summoned for a reevaluation. Seventy patients and respective caregivers agreed to participate. Surgical, demographic and clinical data were reviewed from electronic registries.Two sets of inquiries were performedPediatric Quality of Life Inventory 4.0 (for parent and child) and an adaptation of the Glasgow Children Benefit Inventory (GCBI-b). Fifteen patients were excluded for incomplete inquiries.ResultsFifty-five patients were included, 70.9% were males. Median age at surgery was 7.7 ± 3.3 years. Aesthetic dissatisfaction was the main previous negative experience. Median self-report quality of life was 85.6% and parent-report was 86.9%. Median GCBI-b was +20.5, indicating an improvement in patients’ QoL. Bullying and high parental expectations for life change post-surgery were predictive of higher GCBI-b scores (p < 0.05). Ninety-six percent of parents would recommend surgery to other children.ConclusionsOtoplasty is a valid treatment option for prominent ears in children,improving not only aesthetics but also health-related QoL.     

喉切除术后患者生活质量的评估

目的　评估喉切除术后患者的生活质量及其影响因素 ,以提出相应的对策。方法　以综合生活质量评定问卷、华盛顿大学生活质量头颈调查表、咽喉功能调查表研究了山东大学齐鲁医院42例行喉切除术后的喉癌、下咽癌患者和 38例健康人的生活质量。结果　喉切除术后患者在躯体、心理、社会功能方面显著差于对照组 ;各方面对生活质量影响作用在患者组自大到小依次为 :心理功能、躯体功能、社会功能、物质生活。影响喉切除术后患者生活质量的因素主要有 :患者对病情的估计、工作情况、是否保留喉功能、呼吸情况、讲话情况、容貌、是否拔管等。影响喉切除术后患者心理功能的维度因素按其影响作用依次为躯体功能、社会功能、物质生活。影响患者社会功能的维度因素按其影响作用依次为心理功能、物质生活、躯体功能。喉切除术后患者的生活需求重点前 5位依次为 :身体健康、经济收入、心理健康、社会地位和受人尊重、娱乐生活。结论　全面研究喉切除术后患者的生活质量是十分必要的。喉切除术后患者的生活质量受多种因素影响。争取通过心理干预、临床干预、社会干预的综合作用 ,喉切除术后患者的生活质量可望得到全面提高     

鼻咽癌放疗后口干燥症及其对生活质量的影响

目的观察鼻咽癌患者放疗后口干燥症的情况及其对日常生活的影响,探讨影响口干燥症的相关因素,以期提高鼻咽癌患者的生活质量。方法选择放疗后满1年复查的鼻咽癌患者79例,复查时进行面对面访谈方式的口干问卷调查,根据调查结果分析口干燥症的严重程度及其对生活质量的影响。结果全组口干燥症的发生率为100%,中重度发生率为74.7%,其中13.9%的患者夜晚经常喝水,74.7%的患者吃饭时需饮水,59.5%的患者感到说话困难,91.1%的患者认为日常生活明显受影响。结论鼻咽癌放疗后口干燥症的发生率较高,因此需要一种安全、简便、廉价、有效的方法治疗放疗后口干燥症,以提高患者的生活质量。