第五章 研究討論與建議
第四節 結論
壹、 在單變項分析統計結果，雖然抽菸、喝酒等致癌因子在本研究治療過程 中的相關性未達顯著，而文獻也記載，肺腺癌患者的罹病原因與抽菸並無直
44
接相關，但是，在實證研究報告中，致癌因子仍須被高度關注而不應該被忽 視。
貳、 本研究實證在控制了基本人口學變項下，血紅素及口腔潰瘍情形在多層 次統計模式中，與體能狀態達研究上顯著性的差異，表示血紅素值的變化及 口腔潰瘍在肺腺癌患者行全身性化學治療過程中，或許可以推估患者的營養 狀況。嘔吐的化學治療相關副作用，在多層次統計模式中與體能狀態呈現正 相關，亦達研究上顯著性的差異，或許可以合理的推斷，嘔吐的情形越多，
相對的體能狀況越差。而身體質量指數與食慾在多層次統計模式中，卻與絕 對嗜中性白血球的變化呈現負及正相關，亦達研究上顯著性的差異，或許可 以解釋成身體質量指數越低、食慾越差，可能越容易受感染，相對的，感染 指標白血球攀升的同時，絕對嗜中性白血球經計算後，也會呈現高的數值。
綜合本研究結果，肺腺癌患者行全身性化學治療前後，其血紅素、身體
質量指數以及化學治療副作用嘔吐及食慾與患者在化學治療後之體能狀況及 嗜中性白血球計數有顯著相關，也就是說化學治療前營養狀況越好，化學治 療之後的體能狀態就越能維持或較少有虛弱情形，嗜中性白血球計數也越不 容易有低下情形，可使癌症患者有較好的抵抗力，以及降低被感染的機率。
然而其他變項在本研究結果雖然未達顯著相關，可能與本研究總個案數
太少有關，也或許是因為本研究未將研究對象之共病數納入考量，期許在未 來的研究設計中，研究對象的個案數、家族史、營養相關檢驗數值的完整及 共病數納入研究設計中，讓統計結果能更臻完善、有意義。
參、
一個好的營養指標除了能適度反應病人營養狀況外，還必須兼顧臨床執 行方便性、可行性與連續性，進而反應病人治療成效與副作用的相關性。因 此，本研究用研究對象之血紅素和身體質量指數及體能狀態等營養狀況來探 討肺腺癌患者接受全身性化學治療後的化學治療照護相關性，在臨床上不失 為一個簡易且可信賴的方法。45
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