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根治性上颌骨切除术与保守性上颌骨切除术治疗晚期上颌窦癌后的生活质量

Quality of life in advanced maxillary sinus cancer after radical versus conservative maxillectomy.

作者信息

Liu Liting, Liu Dan, Guo Qiyun, Shen Bin

机构信息

Department of Otolaryngology, Weifang People's Hospital, Weifang, China.

出版信息

J Craniofac Surg. 2013 Jul;24(4):1368-72. doi: 10.1097/SCS.0b013e31828601d6.

Abstract

PURPOSE

A study of patients with advanced maxillary sinus cancer who underwent radical or conservative maxillectomy was performed to show the differences between the 2 groups in patients' survival rate and quality of life (QOL).

METHODS

A total of 61 advanced maxillary sinus cancer patients from Weifang People's Hospital in China were traced: 27 radical maxillectomy and 34 conservative maxillectomy. Survival rate was compared between the 2 groups. Quality of life assessments were performed at the time of preoperation as well as 6, 12, and 18 months after the operation. Measures included the University of Washington-QOL scale (UW-QOL) and the Hospital Anxiety and Depression Scale.

RESULTS

The UW-QOL scale scores of the composite score, appearance, activity, recreation, swallowing, speech, and chewing in the conservative surgical group were much higher than those in the radical surgical group. However, there is no big difference in total survival rate between these 2 groups. Also, no significant difference can be seen in the scores of pain, employment, and shoulder between the 2 groups. At the 6-month follow-up, the radical maxillectomy had more effects on anxiety than the conservative maxillectomy, while they are almost equally effective on depression. The 12-month and 18-month follow-ups showed that the radical maxillectomy made a greater impact on both anxiety and depression than the conservative maxillectomy.

CONCLUSIONS

Conservative maxillectomy is more effective than radical maxillectomy to preserve the QOL of patients with advanced maxillary sinus cancer.

摘要

目的

对接受根治性或保守性上颌骨切除术的晚期上颌窦癌患者进行研究,以显示两组患者生存率和生活质量(QOL)的差异。

方法

对中国潍坊市人民医院的61例晚期上颌窦癌患者进行追踪:27例行根治性上颌骨切除术,34例行保守性上颌骨切除术。比较两组的生存率。在术前以及术后6、12和18个月进行生活质量评估。测量指标包括华盛顿大学生活质量量表(UW-QOL)和医院焦虑抑郁量表。

结果

保守手术组在综合评分、外观、活动、娱乐、吞咽、言语和咀嚼方面的UW-QOL量表评分远高于根治手术组。然而,这两组的总生存率没有太大差异。此外,两组在疼痛、就业和肩部评分方面也没有显著差异。在6个月的随访中,根治性上颌骨切除术比保守性上颌骨切除术对焦虑的影响更大,而它们对抑郁的影响几乎相同。12个月和18个月的随访显示,根治性上颌骨切除术比保守性上颌骨切除术对焦虑和抑郁的影响更大。

结论

对于晚期上颌窦癌患者,保守性上颌骨切除术在保留生活质量方面比根治性上颌骨切除术更有效。

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