膀胱癌患者手术前后生命质量变化及影响因素分析

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目的膀胱癌(bladder cancer,BL)是泌尿系统常见的恶性肿瘤之一,手术是其主要治疗方法。通过分析比较BL患者手术前后生命质量变化及其影响因素,为临床工作开展针对性干预提供证据支持。方法采用方便抽样方法选取2016-01-01-2017-02-01在山东大学附属省立医院泌尿外科住院的118例BL患者为研究对象。采用癌症患者生命质量测定量表体系中的BL量表QLICP-BL(V2.0)和Herth希望量表,调查118例接受BL手术患者手术前和手术后1个月的生命质量和希望水平,并分析一般人口资料和临床特征与生命质量的相关性。结果患者手术前后生命质量总分分别为(74.97±11.92)和(74.70±11.51)分,差异无统计学意义,t=-0.39,P=0.694。生命质量中的共性模块(t=-2.09,P=0.039)以及躯体功能(t=-3.61,P<0.001)、共性症状与副作用维度(t=-2.58,P=0.011)手术后得分显著低于手术前得分,差异均有统计学意义。家庭经济状况、希望水平总分、对现实和未来积极态度对BL患者生命质量具有显著影响。结论 BL患者手术前后生命质量整体处于中等偏上水平,术后早期总体生命质量下降不明显,希望水平对BL患者生命质量有积极作用,通过心理干预和行为指导提高患者希望水平能够改善患者的生命质量。 Bladder cancer (BL) is one of the common malignant tumors in the urinary system. Surgery is the main treatment. By analyzing the changes of the quality of life before and after BL patients and its influencing factors, provide evidence for the clinical interventions to provide targeted evidence. Methods A total of 118 patients with BL who were admitted to Department of Urology, Provincial Hospital Affiliated to Shandong University from January 1, 2016 to February 2, 2016 were selected as the convenient sampling method. Using the QLICP-BL (V2.0) BL scale and the Herth Hope Scale (BL) in the quality of life scale of cancer patients, the quality of life and the level of hope of 118 patients undergoing BL surgery before surgery and one month after surgery were investigated. And analyze the correlation between general population information and clinical features and quality of life. Results The total score of the quality of life before and after the operation was (74.97 ± 11.92) and (74.70 ± 11.51) points respectively, with no significant difference (t = -0.39, P = 0.694). (T = -2.09, P = 0.039), body function (t = -3.61, P <0.001), common symptom and side effect dimension (t = -2.58, P = 0.011) Before surgery, the differences were statistically significant. The economic status of the family, the level of hope and the positive attitude toward reality and future have a significant impact on the quality of life of BL patients. Conclusion The overall quality of life of patients with BL before and after surgery is generally at the upper level, and the overall quality of life is not significantly reduced in the early postoperative period. The level of hope has a positive effect on the quality of life of patients with BL. Improving the patients’ hope by psychological intervention and behavioral guidance can improve their life expectancy quality.
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