膀胱癌患者手术前后生命质量变化及影响因素分析

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.

Analysis of life quality before and after operation and its influential factors in patients with bladder cancer

OBJECTIVE Bladder cancer is one of the most common urologic neoplasms and surgery is the main treatment method.This paper aimed to study the quality of life before and after operation and its influential factors in patients with bladder cancer in order to provide evidence for intervention.METHODS The bladder cancer scale QLICP-BL (V2.0) and the Herth hope scale were used to investigate the quality of life and hope level of 118 patients before and one month after operation with bladder cancer.Correlation analysis was conducted between demographic data,clinical characteristics and quality of life.RESULTS The total score of life quality before and after operation was 74.97±-11.92 and 74.70± 11.51,respectively,and the difference was not statistically significant(t=-0.39,P=0.694).The score of common module as well as the body function,common symptoms and side effects in the quality of life,was significantly lower in postoperative than preoperative(t=-2.09,P =0.039;t =-3.61,P＜0.001;t =-2.58,P =0.011).The results of multivariate regression analysis showed that family economic situation,scores of hope level and the positive attitude towards reality and future had a obvious influence in the quality of life of bladder cancer patients.CONCLUSIONS The overall quality of life of patients with bladder cancer before and after operation is at the middle level,and the decrease of overall quality of life in the early stage after surgery is not obvious,and the hope level has a positive effect on the quality of life of bladder cancer patients.Thus,the psychological intervention,behavioral guidance of patients,and appropriate methods to improve their level of hope after surgery can improve the quality of life of patients.