乳房再造时机和阶段对乳腺癌患者体象和生活质量的影响

目的 探讨乳房再造时机和阶段对行乳腺癌改良根治术患者体象和生活质量的影响.方法 对174例2011年1月至2015年1月在我院行乳房再造术患者进行问卷调查,评价体象情况和生活质量;利用多因素线性回归分析体象和生活质量的影响因素,并探讨再造术时机和阶段的交互作用的独立影响.结果 174例患者的平均年龄为49.20岁.72.41%的患者行即刻乳房再造术,27.59%进行延期乳房再造;所有患者的平均BIS得分为(8.84±7.24)分,平均FACT-G和FACT-B得分为(77.75±15.54)分和(102.61±16.41)分.多因素线性回归分析显示,年龄、婚姻状况、手术满意度、化疗是BIS得分的影响因素(P<0.05);文化程度、手术满意度是FACT-G得分的影响因素(P<0.05);年龄、婚姻状况、化疗、再造术时机是FACT-B得分的影响因素(P<0.05);再造术时机和阶段的交互作用是三者的共同影响因素.不同手术阶段,即刻乳房再造组和延期乳房再造组BIS得分和FACT-B得分变化趋势不同.结论 结合乳腺癌患者乳房再造术时机和阶段体象和生活质量变化情况进行心理干预,对于改善患者体象问题,提高生活质量具有重要意义.

Influencing of timing and stage of breast reconstruction on body image and quality of life in patients with breast cancer

Objective To explore the influence of timing and stage of breast reconstruction on body image and quality of life in patients with breast cancer. Methods In this cross-sectional study, the body image and quality of life of 174 patients, who admitted to our hospital from January 2011 to January 2015, were investigated through question-naires. Multiple regression analyses were used to examine the influencing factors of body image and quality of life, and to explore the independent effect of the interaction of body image and quality of life with controlling for patient age, BMI, marriage, educated level, chemotherapy, radiation therapy, the degree of satisfaction of surgery and major compli-cations. Results A total of 174 patients with a mean age of 49.20 years were enrolled in our study. Of these, patients with immediate reconstruction accounted for 72.41%, and the other 27.59% chose delayed reconstruction. The mean body image score, the mean scores of FACT-G and FACT-B were (8.84 ± 7.24), (77.75 ± 15.54) and (102.61 ± 16.41), re-spectively. Age, marriage, the degree of satisfaction of surgery and chemotherapy were significantly associated with body image score (P<0.05). The educated level and degree of satisfaction were associated with FACT-G score signifi-cantly (P<0.05). Age, marriage, chemotherapy and timing of reconstruction were the influencing factors of FACT-B score (P<0.05). The time and stage of breast reconstruction were significantly associated with both body image and quali-ty of life. Different patterns were observed in body image scores (BIS) and FACT-B score across the reconstructive stag-es in patients who chose the immediate and delayed reconstruction. Conclusion It is significant to maximize body im-age and quality of life of patients undergoing cancer-related breast reconstruction, with delivery of psychosocial treat-ment by considering their changes along with timing and stage of reconstruction.