食管癌姑息治疗患者的生活质量研究.docVIP

内镜下覆膜支架置入对晚期食管癌患者生活质量的影响 赵洁 张南 毛海洲 米文 孙晓利 王薇 解放军第155中心医院 河南 开封 475000 摘要 目的 了解内镜下覆膜支架置入对晚期食管癌患者生活质量的影响。方法 采用欧洲癌症研究与治疗组织生存质量问卷第3版(EORTC QLQ-C30 V3.0)和食管癌专用量表(QLO-OES18)对2004年9月至2008年10月在我院进行覆膜支架置入治疗的伴有吞咽困难的38例无法手术治疗的晚期食管癌患者在治疗前、治疗后1周、4周和12周进行生存质量评估。结果 覆膜支架置入后患者整体生活质量(37.8±14.9 vs. 74.3±10.8；P 0.01)和所有功能领域生活评分显著提高并持续到治疗后12周。患者吞咽困难症状明显改善(18.9±24.5 vs. 90.8±7.9； P0.01).并持续到治疗后12周。梗阻(48.1±27.5 vs. 18.3±30.5；P 0.01)和进食(25.2±15.7 vs. 5.1±18.7；P0.01)等症状方面均有显著改善。结论 覆膜支架置入能够显著提高患者的整体生存质量和全部功能领域评分并能改善患者的吞咽困难和梗阻等症状。 [关键词]内镜 食管癌 覆膜食管支架 恶性食管狭窄 生活质量 Effects on the quality of life in patients with advanced esophageal cancer after membrane covered esophageal stenting ABSTRACT. Objective To investigate effects on the quality of life (QOL) in patients with advanced esophageal cancer after membrane covered esophageal stenting. Method A total of 38 patients with dysphagia due to inoperable esophageal cancer between September 2004 and December 2008 underwent membrane covered esophageal stent placement. The QOL was assessed using Chinese version of European organization for research and treatment of cancer quality of life (EORTC QLQ-C30 V3.0) and EORCT QLQ-Esophagus (OES-18) questionnaire before and at 1, 4, and 12 weeks after placement of the stent. Results The global health status (37.8±14.9 vs. 74.3±10.8; P 0.01) and all functional scores improved significantly after stenting from baseline until 12 weeks. Dysphagia improved significantly immediately after stenting, and this improvement persisted until 12 weeks (18.9±24.5 vs. 90.8±7.9; P 0.01). There was significant improvement in deglutition (48.1±27.5 vs. 18.3±30.5; P0.01) and eating (25.2±15.7 vs. 5.1±18.7; P 0.01) following stenting. Conclusion Membrane covered esophageal stenting resulted in significant improvement in global health status and all functional domain and some symptom scale such as Dysphagia and deglutition。 Key word: endoscope；esophageal carcinoma；membrane covered esophageal stent ；Maligant esophageal stric