肝移植受者生存质量现状及影响因素分析

目的调查肝移植受者生存质量现状，并探讨其影响因素。 方法选取2017年12月在中山大学附属第一医院器官移植科复查的115例肝移植受者，使用一般资料问卷和简明健康调查(SF-36)量表进行调查。采用独立样本t检验比较肝移植组与常模对照组SF-36量表各维度得分，采用单因素方差分析比较不同学历等人口社会学及临床相关资料对生存质量的影响，组间两两比较采用LSD法。计数资料采用频数和构成比表示。P<0.05为差异有统计学差异。 结果共发放问卷115份，回收有效问卷108份，有效回收率93.9%。108例肝移植受者生存质量总分平均为(592±138)分，其中PCS得分平均为(286±71)分，MCS得分平均为(306±75)分；生理机能维度得分最高(86±14)分]，生理职能维度得分最低(55±42)分]。肝移植受者生理机能、生理职能、躯体疼痛、社会功能和情感职能5个维度得分均低于常模，差异均有统计学意义(t＝3.78、6.05、5.54、1.61和0.36，P均<0.01)。以SF-36量表中PCS和MCS作为因变量，分析肝移植受者人口社会学及临床相关资料对生存质量的影响。结果显示，性别、文化程度、月收入、术后生存时间以及术后有无再就业是肝移植受者生存质量的影响因素(P均<0.05)。 结论肝移植受者生存质量还有待提高。医护人员应多关注女性、文化程度较低、月收入较低、术后生存时间<1年、术后未再就业的肝移植受者，提高其生存质量。

Analysis of quality of life and influencing factors in liver transplantation recipients

ObjectiveTo investigate the quality of life (QOL) of liver transplant recipients and explore its influencing factors. Methods115 liver transplant recipients who got reexamination in the Department of Organ Transplantation, the First Affiliated Hospital of Sun Yat-sen University in December 2017 were included into the study, and the general data questionnaire and brief health survey (SF-36) scale were used. The independent sample t-test was used to compare the scores of each dimension of SF-36 scale between the liver transplantation group and the normal control group, and the one-way ANOVA and LSD method was used to compare the effect of demographic sociological and clinical data on the QOL. The counting data were expressed by frequency and constituent ratio. P<0.05 was considered statistically significant. ResultsA total of 115 questionnaires were sent out and 108 valid questionnaires were collected, with an effective recovery rate of 93.9%. The average total scores of QOL of 108 liver transplant recipients was (592±138) scores. the average scores of physical component summary (PCS) and mental component summary (MCS) were (286±71) scores and (306±75) scores, respectively. The scores of physical function dimension was the highest (86±14) scores], and the scores of physical role function dimension was the lowest (55±42) scores]. The scores of physiological function, physical role function, physical pain, social function and emotional function of liver transplant recipients were significantly lower than those of the normal control group (t=3.78, 6.05, 5.54, 1.61 and 0.36, P all<0.01). The effect of demographic sociological and clinical data on QOL of liver transplant recipients were analyzed (the PCS and MCS of SF- 36 scale were used as dependent variables). The results showed that gender, educational level, monthly income, postoperative survival time and postoperative reemployment were the influencing factors of QOL after liver transplantation (P all<0.05). ConclusionThe QOL of liver transplant recipients still needs to be improved. Medical staff should pay more attention to female, low educational level, low monthly income, short lived (less than 1 year) and no re-employment liver transplant recipients, so as to improve their QOL.