使用赝复体修复的上颌骨切除患者的生活质量

Quality of life of maxillectomy patients using an obturator prosthesis.

作者信息

Kornblith A B, Zlotolow I M, Gooen J, Huryn J M, Lerner T, Strong E W, Shah J P, Spiro R H, Holland J C

机构信息

Psychiatry Service, Memorial Sloan-Kettering Cancer Center (MSKCC), New York City, NY 10021, USA.

出版信息

Head Neck. 1996 Jul-Aug;18(4):323-34. doi: 10.1002/(SICI)1097-0347(199607/08)18:4<323::AID-HED3>3.0.CO;2-#.

DOI:10.1002/(SICI)1097-0347(199607/08)18:4<323::AID-HED3>3.0.CO;2-#

PMID:8780943

Abstract

BACKGROUND

The psychosocial adaptation of patients who had undergone a resection of the maxilla for cancer of the maxillary antrum and/or hard palate with the placement of an obturator prosthesis to restore speech and eating function was studied.

METHODS

Forty-seven patients were interviewed who had a maxillectomy with an obturator prosthesis at Memorial Sloan-Kettering Cancer Center, an average of 5.2 years (SD = 2.4 years) ago, 94% of whom had some of their soft palate resected. Interviews were conducted by telephone by a trained research interviewer, using a series of questionnaires to assess their satisfaction with the functioning of their obturator, and the psychological, vocational, family, social, and sexual adjustment. Measures included the Obturator Functioning Scale (OFS). Psychosocial Adjustment to Illness Scale (PAIS), Mental Health Inventory (MHI), Impact of Event Scale, and Family Functioning Scale.

RESULTS

Using multiple regression and discriminant function analyses, satisfactory functioning of the obturator prosthesis, as measured by the OFS, was found to be (1) the most highly significant predictor of adjustment, as measured by the PAIS (p < .0001) and the MHI Global Psychological Distress Subscale (MHI-GPD) (p < .001), and (2) significantly related to their perception of the negative socioeconomic impact of cancer upon their lives. The most significant predictor of better obturator functioning were the extent of resection of their soft palate (one third or less, p < .001), and hard palate (one fourth or less, p < .01). Specific aspects of obturator functioning that most significantly correlated with better adjustment (PAIS, MHI-GPD) were: less difficulty in pronouncing words (r = .40 and r = .51, respectively, p < .01), chewing and swallowing food (r = .27-.46, p < .05), and less change in their voice quality after surgery (r = .52 and r = .56, respectively, p < .001).

CONCLUSIONS

These findings suggest that a well-functioning obturator significantly contributes to improving the quality of life of maxillectomy patients.

摘要

背景

本研究旨在探讨接受上颌骨切除术以治疗上颌窦癌和/或硬腭癌并佩戴阻塞器假体以恢复言语和进食功能的患者的心理社会适应情况。

方法

对47例在纪念斯隆凯特琳癌症中心接受上颌骨切除术并佩戴阻塞器假体的患者进行了访谈，这些患者平均在5.2年前（标准差=2.4年）接受手术，其中94%的患者部分软腭被切除。由一名经过培训的研究访谈员通过电话进行访谈，使用一系列问卷评估他们对阻塞器功能的满意度，以及心理、职业、家庭、社会和性方面的适应情况。测量指标包括阻塞器功能量表（OFS）、疾病心理社会适应量表（PAIS）、心理健康量表（MHI）、事件影响量表和家庭功能量表。

结果

通过多元回归和判别函数分析发现，以OFS衡量的阻塞器假体功能良好是（1）以PAIS（p<.0001）和MHI全球心理困扰子量表（MHI-GPD）（p<.001）衡量的适应情况的最显著预测因素，（2）与他们对癌症对其生活的负面社会经济影响的认知显著相关。阻塞器功能改善的最显著预测因素是软腭切除范围（三分之一或更小，p<.001）和硬腭切除范围（四分之一或更小，p<.01）。与更好的适应情况（PAIS，MHI-GPD）最显著相关的阻塞器功能具体方面包括：发音困难较少（分别为r=.40和r=.51，p<.01）、咀嚼和吞咽食物（r=.27-.46，p<.05）以及术后嗓音质量变化较小（分别为r=.52和r=.56，p<.001）。