【作者】 潘朝斌； 黄洪章； 杨朝晖； 李劲松； 张彬；

【Author】 PAN Chao-bin,HUANG Hong-zhang,YANG Zhao-hui.LI Jin-song,ZHAO Xiao-peng, (Department of Oral and Maxillo-facial Surgery,the Second Affiliated Hospital,Sun Yat-sen University,Guangzhou 510120,China)

【机构】 中山大学附属第二医院口腔颌面外科；

【摘要】 目的:舌鳞癌是口腔癌中发病率最高的肿瘤,影响患者的咀嚼、发音、吞咽、味觉等功能。它的治疗主要治疗手段主要是手术、放疗和化疗,在努力提高生存率同时,对患者的生存质量(quality of life,QOL)评估非常重要。目前国内外对口腔癌QOL总体上都有了不少研究,但我科以华盛顿生存质量问卷(the University of Washington Quality of Life Scale,UW-QOL)第4版对舌癌患者术后长期生存5-15年患者QOL研究,旨在探讨影响舌癌术后患者远期生存质量的因素。方法:首先随机选取1991-2001年间中山大学附属第二医院口腔颌面外科行舌癌治疗后已知无瘤生存达5-15年的56名患者,于2006年7月被邮寄UW-QOL问卷.纳入标准:未曾患过其他癌,或第二原发癌。在2005年9月至2006年9月期间对41例舌癌手术后3个月门诊复诊患者中,选择平均年龄、男女比例、T分期的构成近似长期生存组的患者19名填写UW-QOL问卷。纳入标准:未发现舌癌复发或原处转移。结果:长期生存舌癌患者的年龄、临床分期、有无节段性下颌骨切除、有无术后放疗等因素影响总的QOL。另外,年龄因素对工作项有明显影响;T stage因素对吞咽、语言有明显影响,临床分期因素也对吞咽、语言有明显影响;RND,FND因素对面容外形、肩功能有明显影响;游离皮瓣修复仅对语言有明显改善;下颌骨节段性切除因素对外形和咀嚼项得分明显降低,下颌骨方块切除因素仅对咀嚼有明显影响;术后放疗因素明显影响患者项的疼痛、行动、咀嚼、吞咽、涎腺、味觉、肩功能、心情。长期生存组与术后3个月对照组比较:在疼痛、娱乐、工作、吞咽、语言、心情、焦虑和总的QOL项上存在显著性差异。结论:UW-QOL第4版可以较好地评价舌癌术后患者生存质量,其反映影响QOL的临床因素,主要是患者的年龄、临床分期、有无节段性下颌骨切除、有无术后放疗。更多还原

【Abstract】 Objectives:Tongue cancer has most incidences in oral cancer,which affects jawing,speech,swallowing and taste.Its treatment included surgery,radiotherapy and chemotherapy.It is important to assess QOL while we try to raise survival rate of patients. A study of patients QOL of tongue cancer who survived 5-15 years was to investigate the factors which affect the QOL of patients. Methods:The University of Washington Quality of Life Scale(UW-QOL) questionnaires were send to fifty-six patients underwent tongue cancer radical surgery survived 5-15years without other neplosams or the second primary neplosams.Nineteen patients underwent tongue cancer radical surgery without recurrence and metabasis as contrast were interviewed by same questionnaire in out patients clinic.Results:There were favorable responses on UW-QOL in respect of age,overall stage,segmental mandible resection and radiotherapy domains,in addition,there were differences in employment on age domains,swallow and speech in T stage and overall stage,appearance and shoulder between RND and FND,speech in free flap,chewing in mandible resection,pain,activity,recreation, jaw,shoulder,taste and salivary in radiotherapy.There were differences in patients between 5-15 years and 3 months in pain, recreation,employment,swallowing,speech,mood,anxious and sum scores.Conclusion:UW-QOL 4th can effectively evaluated QOL, some factors such as age,overall stage,segmental mandible resection and radiotherapy could affect QOL of tongue cancer patients.更多还原