中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2020, Vol. 42 ›› Issue (5): 632-639.doi: 10.3881/j.issn.1000-503X.12993

• 论著 • 上一篇    下一篇

甲状腺微小乳头状癌患者射频消融术后生活质量的相关影响因素分析

兰雨1,2,金壮2,张明博2,宋青2,肖静1,2,阎琳2,罗渝昆1,2()   

  1. 1 南开大学医学院影像医学与核医学专业,天津 300071
    2 中国人民解放军总医院第一医学中心超声科,北京 100853
  • 收稿日期:2020-05-20 出版日期:2020-10-30 发布日期:2020-11-02
  • 通讯作者: 罗渝昆 E-mail:lyk301@163.com
  • 基金资助:
    国家自然科学基金(81771834)

Factors Affecting Quality of Life of Patients Undergoing Radiofrequency Ablation for Papillary Thyroid Microcarcinoma

LAN Yu1,2,JIN Zhuang2,ZHANG Mingbo2,SONG Qing2,XIAO Jing1,2,YAN Lin2,LUO Yukun1,2()   

  1. 1 Imaging and Nuclear Medicine,Medical College of Nankai University,Tianjin 300071,China
    2 Department of Ultrasound,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China
  • Received:2020-05-20 Online:2020-10-30 Published:2020-11-02
  • Contact: LUO Yukun E-mail:lyk301@163.com
  • Supported by:
    National Natural Sciences Foundation of China(81771834)

摘要:

目的 评估甲状腺微小乳头状癌(PTMC)患者行超声引导下射频消融术后健康相关生活质量(HRQoL)的影响因素。方法 回顾性分析2019年10月至12月在中国人民解放军总医院超声诊断科进行射频消融术后复查的100例PTMC患者的临床资料,收集患者的人口学信息,采用SF-36和甲状腺癌特异性健康相关生活质量量表分别评估患者的生活质量和甲状腺相关特异性症状。SF-36量表包括躯体健康(PCS)和精神健康(MCS)两个总维度。分析人口学特征及射频消融术后甲状腺相关症状对PTMC患者SF-36量表中PCS及MCS分数的影响。结果 单因素及相关性分析结果显示,PTMC患者生活质量中PCS分数与性别、神经肌肉、声音、注意力、交感神经、喉咙和口腔、心理、感觉症状、瘢痕、感觉寒冷、刺痛感、头痛症状有关(P均<0.1);MCS分数与文化程度、常住地、神经肌肉、声音、注意力、交感神经、喉咙和口腔、心理、感觉症状、瘢痕、感觉寒冷、刺痛感、头痛症状相关(P均<0.1)。多因素线性回归分析表明,PCS分数仅与性别、心理、神经肌肉、喉咙和口腔的症状相关,回归方程为PCS=110.367-8.025×性别-0.213×心理-0.280×神经肌肉-0.278×喉咙/口腔;MCS分数仅与心理、喉咙和口腔、注意力集中的相关症状相关,回归方程为:MCS=91.323-0.237×心理-0.437×喉咙/口腔-0.304×注意力集中。结论 影响超声引导下射频消融术后PTMC患者生活质量的主要危险因素是女性患者、心理负担、注意力不集中、神经肌肉及喉咙口腔的相关症状。因此,应根据患者可能报告的相关症状做好术前交代,并在术后有针对性的进行心理干预,进而提高PTMC患者治疗后的生活质量。

关键词: 射频消融, 超声, 生活质量, 甲状腺微小乳头状癌

Abstract:

Objective To evaluate the factors affecting health-related quality of life (HRQoL) of patients with thyroid papillary microcarcinoma (PTMC) after ultrasound-guided radiofrequency ablation (RFA).Methods The clinical data of 100 patients with PTMC who underwent reexamination after RFA in the Ultrasound Department of our center from October to December 2019 were retrospectively analyzed.Demographic information was collected.SF-36 and Thyroid Cancer-specific Health-related Quality of Life Questionnaire scales were used to assess patients’ quality of life and thyroid-related specific symptoms.The SF-36 scale includes two general domains including physical component summary (PCS) and mental component summary (MCS).The impacts of demographic characteristics and thyroid-related symptoms after RFA on PCS and MCS scores were further analyzed.Results Univariate analysis and correlation analysis showed that the PCS scores in quality of life of PTMC patients were related to sex, neuromuscular, voice, concentration, sympathetic nerve, and throat/mouth complaints, psychological state, sensory symptoms, scar, chills, tingling, and headache (all P<0.1);and the MCS scores were associated with education level, residence, neuromuscular, voice, concentration, sympathetic nerve, and throat/mouth complains, psychological state, sensory symptoms, scar, chills, tingling, and headache (all P<0.1).Multivariate regression analysis showed that the PCS scores were only associated with sex and the neuromuscular and throat/mouth complains and the psychological state.The regression equation was:PCS=110.367-8.025×sex-0.213×psychological state-0.280×neuromuscular complain-0.278×throat/mouth complain.In contrast, the MCS scores were only associated with the psychological state and the throat/mouth and concentration complains, with the regression equation being:MCS=91.323-0.237×psychological state-0.437×throat/mouth-0.304×concentration.Conclusions The main risk factors affecting the quality of life of PTMC patients after ultrasound-guided RFA were female gender, psychological burden, lack of attention, and symptoms in neuromuscular system and throat/mouth.Therefore, preoperative explanations should be made according to the relevant symptoms that the patients may report, and psychological interventions should be offered after RFA to improve the quality of life of PTMC patients after treatment.

Key words: radiofrequency, ultrasound, quality of life, papillary thyroid microcarcinoma

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