海南医科大学学报

目的：探究海南省某三甲医院肺癌手术后在院患者生命质量现状及其影响因素。方法：采用横断面调查研究方法，对海南省某三甲医院肺癌手术后在院患者进行调查，探究肺癌手术后在院患者生命质量的影响因素。结果：海南省某三甲医院186名肺癌手术后在院患者的失眠症状、食欲丧失症状、便秘症状疼痛症状领域得分明显高于参考值。多重线性回归分析显示，年龄大（>60岁）的患者躯体功能领域得分低（β=-0.193），女性患者食欲丧失症状明显（β=0.245）；汉族较其他少数民族角色功能领域得分低（β=0.179），汉族（β=-0.162）疲倦症状重，少数民族总体健康水平高（β=0.166）；职工医保的患者情绪功能得分较低（β=0.194），认知功能得分较低（β=0.281），社会功能领域得分最低（β=0.188），其他部位痛的症状重（β=-0.227）；吸烟患者咳嗽症状比不吸烟患者轻（β=0.175），手臂肩膀痛症状重（β=-0.21）；有二手烟接触的患者认知功能得分较低（β=-0.158），口腔溃疡的症状明显（β=0.185）；经常饮酒的患者（饮酒频率>1次/天）咳嗽症状重（β=0.27）；子女数量少（0～1个）的患者咳嗽症状轻（β=0.178）；不了解病情的患者手臂肩膀痛的症状明显（β=0.151）；肺癌病理分期较早的患者（Ⅰ～Ⅱ期）气促症状重（β=-0.159），疼痛症状重（β=-0.181）；居住在城市的患者食欲丧失症状明显（β=0.192）；外周神经病变的症状更为明显（β=0.174）；经常食用腌制食物的患者疼痛症状重（β=-0.219），其他部位痛（β=-0.149）症状明显；男性患者脱发症状明显（β=-0.306）。结论：年龄、民族、居住地归属、医保类型、子女数量、肺癌病理分期、吸烟、二手烟接触、饮酒、经常食用腌制食物等因素与肺癌手术后在院患者生命质量相关；在肺癌手术后在院患者的治疗过程中，医护人员及病人家属应注意患者的情绪沟通；患者应避免吸烟、饮酒与二手烟的接触，减少食用腌制食物。

Objective: To explore the current status and influencing factors of quality of life in patients with lung cancer after surgery in a tertiary hospital in Hainan province. Methods: To investigate the influencing factors of quality of life of lung cancer patients after surgery in a tertiary hospital in Hainan province by cross-sectional survey method. Results: The scores of insomnia, appetite loss, constipation and pain in 186 lung cancer patients after surgery in a tertiary hospital in Hainan Province were significantly higher than the reference value. Multiple linear regression analysis showed that older patients(> 60 years) had lower scores in physical function domain(β=-0.193), and female patients had more appetite loss symptoms(β=0.245). Compared with other minority ethnic groups, Han ethnic group had lower scores in role function domain(β=0.179), more severe fatigue symptoms(β=-0.162), and higher general health level(β=0.166). Patients with employee medical insurance had lower scores of emotional function(β=0.194), cognitive function(β=0.281), the lowest score in social function(β=0.188), and severe pain in other parts(β=-0.227). Smokers had less cough symptoms(β=0.175) and more arm and shoulder pain symptoms(β=-0.21) than non-smokers. Patients with secondhand smoke exposure had lower cognitive function scores(β =-0.158) and more obvious symptoms of oral ulcer(β=0.185). Patients who drank alcohol frequently(drinking frequency > 1 time/day) had more severe cough symptoms(β=0.27). Patients with small number of children(0-1) had milder cough symptoms(β=0.178). Patients who did not understand the disease had obvious symptoms of arm and shoulder pain(β=0.151). Patients with early pathological stage(stage I-II) had more severe shortness of breath(β=-0.159) and pain(β=-0.181). The symptoms of appetite loss were more obvious in patients living in cities(β=0.192). The symptoms of peripheral neuropathy were more obvious(β=0.174). Patients who often consumed pickulated food had severe pain symptoms(β=-0.219), and pain in other parts was obvious(β=-0.149).Male patients had obvious alopecia symptoms(β=-0.306). Conclusion: Age, ethnicity, residence, type of medical insurance, number of children, pathological stage of lung cancer, smoking, second-hand smoke exposure, alcohol consumption, and frequent consumption of pickled food were related to the quality of life of lung cancer patients in hospital after surgery. Medical staff and family members should pay attention to the emotional communication of patients during the treatment of lung cancer patients in hospital after surgery. Patients should avoid exposure to smoking, alcohol and second-hand smoke, and reduce consumption of pickled food.