目的:通过整理分析宁养肝癌患者的临床资料,了解宁养肝癌患者的总体生存时间,探讨影响肝癌生存预后的独立影响因素,从而为肝癌的防治提供指导。方法:收集广西医科大学第一附属医院宁养院2010年6月至2012年12月期间肝癌病人的病历资料,并进行随访调查及回顾性研究,采用Kaplan-Meier法分析中位生存期和生存率,log-rank法比较生存率差异,多因素分析采用Cox比例风险模型。结果:宁养肝癌病人的中位生存期为5.0个月,平均生存期为8.7个月,3个月累积生存率为(73.2±2.6)%,6个月累积生存率为(43.3±2.9)%。单因素分析显示,患者的性别、是否接受过相关治疗(手术治疗、化疗或放疗)、出现疼痛的时间以及对病情的了解程度,与患者生存预后相关;Cox回归分析显示,患者是否接受过手术治疗、出现疼痛的时间和对病情的了解程度是影响宁养肝癌患者预后的主要独立因素。结论:患者是否接受手术治疗、出现疼痛的时间和对病情的了解程度是宁养肝癌生存预后的独立影响因素,因此,早发现、早诊断,让患者清楚自身疾病,并积极的接受有效地手术治疗和辅助放化疗有助于提高肝癌患者的总体生存时间。
Objective. To explore the factors affecting the survival time in patients with liver cancer in hospice care and to provide evidence for clinical prevention and treatment of cancer. Methods. Patients with liver cancer who received service of hospice from January 2010 to December 2012 were taken part in followup survey and retrospective analysis. The median survival time and cumulative survival rate were assessed by the Kaplan-Meier method while the significant difference was evaluated by the log-rank test. Multivariate analysis of variables was performed by the Cox proportional hazard regression model. Results: The median survival time of all patients who died of liver cancer was 5.0 months and the average survival time was 8.7 months. The 3-month cumulative survival rate was (73.2±2.6)G and the 6-month cumulative survival rate was (43.3±2.9) %. The result of univariate analysis revealed that the factors affecting the prognosis included gender receiving relative operations or not, chemotherapy, radiotherapy, time of pain appearing and awareness of their illness. Multivariate step-wise regression analysis revealed that receiving operatlons or not, t of the survival ness of their il me of pain appearing and awareness of their illness were the independent prognostic factors time of patients. Conclusion: Receiving operations or not, time of pain appearing and awareness are the independent prognostic factors of the survival time in patients with liver cancer. Early detection, improving cognition of the disease, effective operation and appropriate adjuvant chemo-ra diotherapy could prolong the survival time of patients with liver cancer.