北京市卵巢恶性肿瘤患者手术加化疗前后生命质量比较研究

目的 了解北京市卵巢恶性肿瘤患者治疗前、治疗中、治疗后的生命质量（quality of life，QOL），观察其变化趋势，分析相关影响因素，探讨提高QOL的措施。方法 对175例接受手术+化疗的卵巢恶性肿瘤患者在治疗前后4个时间段，即手术前1天、第1次化疗后、第4次化疗后、化疗结束后的第1次随诊，用WHO制定的卵巢恶性肿瘤治疗功能评价系统之生命质量问卷（QOL-OC）进行生命质量的评分。结果 QOL-OC问卷总量表的同质性信度为0.176，各项目与其所属因子的相关系数基本大于与其他因子的相关系数。患者QOL得分在第1次化疗后明显下降，到第4次化疗后有所上升，化疗结束后升至或稍高于手术前水平。身体状况、其他忧虑、生活能力得分呈先降低后升高的趋势，其他忧虑得分在第1次化疗后下降得最明显，而情绪得分上升，社会/家庭、与医生的关系得分较稳定。治疗前，情绪得分最低，其次为生活能力和身体状况；临床分期越晚，得分越低；公费、在城市生活、有职业、文化程度高的患者得分比自费、在农村生活、无职业、文化程度低患者高。结论 QOL-OC问卷有尚好的信度和效度，可用于我国卵巢恶性肿瘤患者QOL的初步调查研究。患者的QOL在治疗前后呈现先下降后回升的趋势，与社会、家庭的支持相关。在手术前，得分最低的项目为情绪，故应加强患者的术前心理引导。社会/经济状况、肿瘤分期是影响患者QOL的主要因素；应给予农村、无职业、文化程度低、自费的患者更多的帮助。

Analysis of Quality of Life in Beijing Patients With Ovarian Cancar

Objective To investigate the quality of life (QOL) of ovarian cancer (OC) patients and its influential factors as well as to explore the method for improving the QOL in this population of patients.Methods A QOL questionnaire for ovarian cancer (QOL-OC) was designed and used in a survey of 75 OC patients before they got any treatment,during the treatment and after finished.Results Advanced stage patients showed significantly poor phydical well-being, emotional well-being, and functional well-being, as compared with early stage patients. QOL was reported higher in patients above high school education, and with well-education. The patients got poor score with psychological status items before treatment, while those who had been treated for a period of time got poor score with social characteristics items, especially with the work and sexuality items. Stage were the main influential factors of the QOL in the OC patients.Conclusion Patients with later stage, poor education, and in the rural patients have the most significant impairments and need more support. Psychosocial factors play very important roles in the OC patients. As a result, psychosocial interventions should be stressed in the rehabilitation of this population of patients.