背景:骨肿瘤对于骨科医生来说仍然是一个巨大的挑战。在发展中国家,有限的诊断加剧了挑战,治疗性的,管理设施和无知。患有上肢和下肢肌肉和骨骼肿瘤的患者是截肢或手术抢救四肢的候选人。传统上,新辅助化疗的肢体抢救手术是局部癌的首选手术方法。截肢通常保留给肿瘤大小增加的患者。这项研究的目的是调查健康相关的生活质量(HRQOL)和身体残疾,专注于外科护理,性别,和年龄,在接受手术治疗的恶性骨肿瘤的青少年和年轻成人幸存者中。
方法:这项横断面研究由38名在乔治国王医科大学接受截肢或保肢手术的长期幸存者组成,勒克瑙,从2019年到2022年。在获得道德许可和知情同意后,研究包括38例患者,其中A组26例接受保肢治疗,B组12例接受截肢治疗。SF-36和HUI3评分用于评估这些患者的功能结局和健康相关QoL。
结果:经过最少6个月的干预,我们发现以下所有因素都有显著改善:身体功能(P=0.000),由于身体健康(P=0.000)和情绪问题(P=0.001)的角色限制,能量/疲劳(P=0.000),情感幸福感(P=0.000),社会功能(P=0.000),疼痛(P=0.000),和一般健康状况(P=0.000)。通过SF-36(简短表格-36,患者报告的结果),A组比B组显示出更高的显著性,而HUI-3没有显示任何显著的结果(P=0.347)。
结论:在肿瘤存活患者中,抢救肢体患者的总体生活质量似乎高于截肢患者的生活质量。必须进行进一步的分析,以验证结果,并使用其他评估工具将重点放在对整体生活质量有重大影响的领域。治疗对生活质量的影响取决于维持功能功能的必要结构,调整患者对癌症治疗的期望,并设计长期康复计划以支持功能功能。
BACKGROUND: Bone tumors remain a formidable challenge for orthopedic surgeons. In developing countries, the challenge is exacerbated by limited diagnostic, therapeutic, and management facilities and ignorance. Patients with upper and lower-extremity muscle and skeletal tumors are candidates for amputation or surgical rescue of the limbs. Traditionally, limb rescue surgery by neo-adjuvant chemotherapy is the preferred surgery method for localized carcinoma. Amputations are usually reserved for patients with increased tumor size. The purpose of this study is to investigate health-related quality of life (HRQOL) and physical disability, focusing on surgical care, gender, and age, in adolescent and young adult survivors of malignant bone tumors treated surgically.
METHODS: This cross-sectional study consists of 38 long-term survivors who underwent amputation or limb-salvage surgery at King George\'s Medical University, Lucknow, from 2019 to 2022. After obtaining ethical clearance and informed consent, 38 patients which included 26 patients treated with limb salvage in Group A and 12 patients treated with amputation in Group B were included in the study. The SF-36 and HUI3 scores were used to assess the functional outcome and health-related QoL of these patients.
RESULTS: After minimal six months of interventions, we have found a significant improvement in all the following factors: physical functioning (P=0.000), role limitations due to physical health (P=0.000) and emotional problems (P=0.001), energy/fatigue (P=0.000), emotional well-being (P=0.000), social functioning (P=0.000), pain (P=0.000), and general health (P=0.000). Group A showed a higher degree of significance than Group B through SF-36 (Short Form-36, patient-reported outcome), whereas HUI-3 did not show any significant outcomes (P=0.347).
CONCLUSIONS: The overall quality of life of patients with salvaged limbs appears to be higher than that of the quality of life of amputee patients in tumor survivor patients. Further analyses must be carried out to verify the results and focus on areas that have a major impact on the overall quality of life using other assessment tools. The impact of therapy on the quality of life depends on maintaining the necessary structures for functional functions, adjusting patient expectations to cancer treatments, and designing long-term rehabilitation programs to support functional functions.