Luo Jie, Wu Jieli, Lv Kexing, Li Kaichun, Wu Jianhui, Wen Yihui, Li Xiaoling, Tang Haocheng, Jiang Aiyun, Wang Zhangfeng, Wen Weiping, Lei Wenbin
From the Otorhinolaryngology Hospital, Otorhinolaryngology Institute, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China (JL, JL W(Jieli Wu), KX L(Kexing Lv), YW, HT, AJ, ZW, WW, WL); Tianyou Hospital Affiliated to Tongji University, Shanghai, China (JL, KC L(Kaichun Li)); Otorhinolaryngology Institute, Meizhou People's Hospital, Meizhou, Guangdong, China (JW); and The Fourth People's Hospital of Shenzhen (Affiliated Futian Hospital of Guangdong Medical College), Shenzhen, China (XL).
Medicine (Baltimore). 2016 Jan;95(1):e2363. doi: 10.1097/MD.0000000000002363.
This study aims to analyze the postsurgical health-related quality of life (HRQOL) and quality of voice (QOV) of patients with laryngeal carcinoma with an expectation of improving the treatment and HRQOL of these patients. Based on the collection of information of patients with laryngeal carcinoma regarding clinical characteristics (age, TNM stage, with or without laryngeal preservation and/or neck dissection, with or without postoperative irradiation and/or chemotherapy, etc.), QOV using Voice Handicap Index (VIH) scale and HRQOL using EORTC QLQ-C30 and EORTCQLQ-H&N35 scales, the differences of postsurgical HRQOL related to their clinical characteristics were analyzed using univariate nonparametric tests, the main factors impacting the postsurgical HRQOL were analyzed using regression analyses (generalized linear models) and the correlation between QOV and HRQOL analyzed using spearman correlation analysis. A total of 92 patients were enrolled in this study, on whom the use of EORTC QLQ-C30, EORTC QLQ-H&N35 and VHI scales revealed that: the differences of HRQOL were significant among patients with different ages, TNM stages, and treatment modalities; the main factors impacting the postsurgical HRQOL were pain, speech disorder, and dry mouth; and QOV was significantly correlated with HRQOL. For the patients with laryngeal carcinoma included in our study, the quality of life after open surgeries were impacted by many factors predominated by pain, speech disorder, and dry mouth. It is suggested that doctors in China do more efforts on the patients' postoperative pain and xerostomia management and speech rehabilitation with the hope of improving the patients' quality of life.
本研究旨在分析喉癌患者术后与健康相关的生活质量（HRQOL）和嗓音质量（QOV），以期改善这些患者的治疗和HRQOL。基于收集喉癌患者的临床特征（年龄、TNM分期、有无喉保留和/或颈清扫、有无术后放疗和/或化疗等）信息，使用嗓音障碍指数（VIH）量表评估QOV，使用欧洲癌症研究与治疗组织核心量表（EORTC QLQ-C30）和欧洲癌症研究与治疗组织头颈癌量表（EORTC QLQ-H&N35）评估HRQOL，采用单变量非参数检验分析术后HRQOL与其临床特征的差异，采用回归分析（广义线性模型）分析影响术后HRQOL的主要因素，并采用Spearman相关分析分析QOV与HRQOL之间的相关性。本研究共纳入92例患者，对其使用EORTC QLQ-C30、EORTC QLQ-H&N35和VHI量表的结果显示：不同年龄、TNM分期和治疗方式的患者HRQOL差异显著；影响术后HRQOL的主要因素为疼痛、言语障碍和口干；QOV与HRQOL显著相关。对于本研究纳入的喉癌患者，开放手术后的生活质量受多种因素影响，其中疼痛、言语障碍和口干占主导。建议我国医生在患者术后疼痛管理、口腔干燥管理和言语康复方面加大力度，以期提高患者的生活质量。
