ObjectiveTo investigate the supportive care needs (SCNs) and quality of life (QOL) of patients with thyroid cancer at different time points, and explore the trends and relation between the two. MethodsFrom April 2020 to July 2020, the convenience sampling method was used to select the patients with thyroid cancer that met the criteria, and the general data were collected before discharge. The 34-item Supportive Care Needs Survey and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 were used to investigate the SCNs and QOL of patients at preoperative 1 d and postoperative 2 d, 1 month and 6 months. ResultsA total of 102 patients met the criteria were included. Total score of SCNs (F=13.407, P<0.001) and the points of psychological (F=38.525, P<0.001), health information (F=7.935, P=0.006), physical and daily living (F=56.413, P<0.001), patient care and support (F=40.530, P<0.001) needs were statistically different at each time point. The highest need was the psychological need at preoperative 1 d, which was the health information need at each time point after operation, and total score of SCNs was the highest at postoperative 2 d. The points of physical function (F=18.490, P<0.001), cognitive function (F=86.943, P<0.001), emotional function (F=9.121, P=0.003), social function (F=7.117, P=0.009), and overall health status (F=3.156, P=0.039) were statistically different at each time point, which of the physical function, role function, emotional function, social function, and overall health status decreased to the lowest on day 2 after operation. The total score of SCNs at each time point was negatively correlated with the functional factors of the QOL and the overall health status score (P<0.05). ConclusionsThe SCNs and QOL of patients with thyroid cancer show different trends at different time points, and there is a correlation between the two. Medical staff needs to develop personalized interventions according to the different stages of the patients’ disease, and actively provide targeted support and care so as to improve their QOL.
ObjectiveTo analyze the influencing factors of fear of cancer recurrence (FCR) and its correlation with social support and quality of life in patients with differentiated thyroid cancer (DTC) at 5 years after surgery. MethodsA total of 116 patients with DTC from West China Hospital, Sichuan University at 5 years after surgery were selected as the research objects. The patients were investigated using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Social Support Rating Scale (SSRS) and the European Organization for Reasearch and Treatment of Cancer Quality of Life Questionnare-Core 30 (EORTC QLQ-C30, hereinafter referred to as QLQ-C30). The χ2 test or Fisher exact probability method were used for univariate analysis, and multivariate logistic regression analysis was used for influencing factor analysis. The diagnostic value of variables with significant influence on FCR in multivariate logistic regression was further studied by receiver operating characteristic (ROC) curve, and Pearson correlation analysis was finally adopted to analyze the relationship between FCR and social support and quality of life in patients with DTC at 5 years after operation. ResultsThe questionnaire survey showed that the FoP-Q-SF score of 116 patients with DTC at 5 years after surgery was (35.92±2.52) scores, of which 75 patients had FoP-Q-SF score ≥34 scores, 41 patients had FoP-Q-SF score <34 scores, and the FCR rate was 64.66% (75/116). Multivariate logistic regression showed that gender, family annual income, SSRS score and total QLQ-C30 score were the main factors of FCR in patients with DTC at 5 years after surgery (P<0.05). Further ROC curve diagnosis showed that the accuracy rate of diagnosis of FCR with SSRS score ≤47.5 scores was 70.70%, the total score of QLQ-C30 ≤617.225 scores was 69.02%. The accuracy rate of diagnosis of FCR was 66.03% when the annual income of family was less than 150 000 yuan. The accuracy of women’s diagnosis of FCR was 62.28%. Pearson correlation analysis showed that FoP-Q-SF score was negatively correlated with SSRS score and total score of QLQ-C30 in DTC patients at 5 years after operation (r=–0.629 6, P=0.000 1; r=–0.568 5, P=0.000 1). ConclusionsThe proportion of patients who have FCR at 5 years after DTC operation is high, and gender, family annual income, SSRS score and total score of QLQ-C30 are the influencing factors. Therefore, we can develop targeted management strategies to reduce patients’ FCR and improve their quality of life.
【摘要】 目的 比较在乳腺癌Auchincloss改良根治术中使用超声刀及电刀手术的优、缺点。 方法 2009年6月－2010年7月将176例乳腺癌患者通过信封法随机分为超声刀组和电刀组，每组88例，分别比较两组患者手术时间、术中出血量、淋巴结检出数目、术后引流量、皮下积液及术后出血量的差异。 结果 手术时间:超声刀组为（145.72±50.76） min，电刀组为（171.27±66.68） min，两组差异有统计学意义（P=0.005）；术中出血量:超声刀组为（71.56±31.34） mL，电刀组为（84.99±36.39） mL，两组差异有统计学意义（P=0.009）；清扫出的淋巴结个数:超声刀组为（20.92±9.09）个，电刀组为（17.90±6.74）个，两组差异有统计学意义（P=0.013）。而在术后平均引流量和术后积液例数方面两组的差异无统计学意义（Pgt;0.05）。两组均无术后出血的情况。 结论 在乳腺癌Auchincloss改良根治术中使用超声刀，较单独使用电刀能缩短手术时间，减少出血量，并增加淋巴结检出的数量。【Abstract】 Objective To compare the disadvantages and advantages between modified radical mastectomy with harmonic scalpel (HS) and conventional electro-scalpel (ES) for patients with breast cancer. Methods Between June 2009 and July 2010, 176 patients with breast cancer were randomly divided into two groups including the HS group and the ES group. The operation time, intra-operative bleeding volume, the number of lymph nodes detected, postoperative drainage volume, subcutaneous hydrops, and postoperative hemorrhage volume between the two groups of patients were compared. Results There were significant differences between the HS and ES groups in terms of operation time [(145.72±50.76) minutes vs. (171.27±66.68) minutes, P=0.005], intra-operative bleeding volume [(71.56±31.34) mL vs. (84.99±36.39) mL, P=0.009], and number of lymph nodes detected (20.92±9.09 vs. 17.90±6.74, Plt;0.05). The postoperative drainage volume and subcutaneous hydrops were not significantly different between the two groups (Pgt;0.05). No postoperative hemorrhage occurred in both groups. Conclusion Compared with ES, the use of HS can reduce operation time and intra-operative bleeding volume, and increase the number of lymph nodes detected during modified radical mastectomy.
ObjectiveTo understand the follow-up needs of postoperative patients with thyroid cancer and analyze its influencing factors, so as to provide a reference for the establishment of a follow-up management system for patients with thyroid cancer.MethodsConvenience sampling was used to conduct a questionnaire survey on the follow-up need, recovery, anxiety, and stress of patients after thyroid cancer surgery in 2 tertiary A hospitals from March to April in 2020. The self-designed follow-up needs questionnaire, the Quality of Recovery Questionnaire 15 (QoR-15), the Generalized Anxiety Disorder-7 (GAD-7), and the Perceived Stress Scale (PSS-4) were scored. The higher score, the higher need, the better recovery, and the more serious anxiety and stress.ResultsIn this study, 382 questionnaires were distributed, which of 351 were returned and of 349 were valid, the valid callback rate was 99.4% (349/351). ① Follow-up needs. Follow-up form: Online platform was the preferred follow-up method (72.2%), the most patients hoped that the follow-up would be conducted by a doctor (82.5%) and hoped to start the follow-up at 1 month after the operation (67.6%) and in the afternoon (50.7%), the duration of each follow-up was 10–15 min (47.3%), and accepted the follow-up frequency of 1 times per month (41.3%) and the lifetime follow-up (69.9%). Needs degree of follow-up contents: There were 13 follow-up items requiring more than 80% of patients. The top 5 items with the higher follow-up needs score were the question on test results, returning visit guidance, knowledges of metastasis and recurrence, medication guidance, and issuance of inspection orders, and their scores were 4.78±0.47, 4.70±0.51, 4.70±0.57, 4.65±0.59, 4.57±0.64, respectively. The results of multiple linear regression analysis were found that the age (young), marital status (unmarried), medical payment method (with medical insurance), and postoperative interval (<1 month) were closely related to the follow-up needs score (P<0.05). ② Recovery, anxiety, and stress statuses: The total QoR-15 score of patients was 79.87±29.95, which was positively correlated with the total score of follow-up needs (72.93±8.52, r=0.131, P=0.014). No significant correlation was found between the total score of GAD-7 (4.77±3.59) or PSS-4 (6.51±3.10) and the total score of follow-up needs (r=0.068, P=0.207; r=0.008, P=0.881).ConclusionsYoung, unmarried, medically insured, and early postoperative patients with thyroid cancer have higher follow-up needs. Patients with better recovery after surgery have a higher follow-up needs. Medical staff should pay attention to follow-up services after discharge, rationally arrange content, frequency, and time period of follow-up according to follow-up needs of patients, so as to improve quality of medical services.
【Abstract】ObjectiveTo introduce the minimally invasive excision and biopsy of breast neoplasm with Mammotome vacuum device guided by ultrasound. MethodsFiftytwo breast masses were detected in 30 patients through color Doppler. The ages of these patients range from 18 years to 49 years. Forty-six of those masses (88.5%) were clinically impalpable. Complete excision and biopsy of 52 breast masses were performed using Mammotome vacuum device guided by ultrasound. The patients were followed up and their postoperative condition were recorded. ResultsFiftytwo breast masses of 30 cases were excised completely, which was verified by color Doppler.The tissue excised by Mammotome were enough for pathological examination. Fortysix masses were proved to be fibroadenoma and the other 6 were proved to be adenosis. Hematoma was found in four patients after operation. The incisions were small and hidden, and the appearance of breasts remained well. Twenty patients were followed up for a shot period of time and no residual nidus or recurrence of the mass was found.ConclusionMinimally invasive excision and biopsy of breast masses with Mammotome vacuum device is an accurate and safe method. It is an ideal minimally invasive operation in treating benign breast neoplasm with few complications. It can be applied to biopsy of breast masses and complete excision of benign breast masses which are less than 2 cm in the same time.