局限性肾癌患者腹腔镜手术前后生活质量初步调查分析

目的：评测局限性肾癌患者腹腔镜手术前后生活质量（QoL），并探讨其变化趋势。方法使用健康调查简表（SF-36）中文版对49例接受腹腔镜手术的局限性肾癌患者进行 QoL 评测，所有纳入对象于术前1 d、术后3个月和术后6个月分别填写调查问卷并评分。将 QoL 8个维度术前得分与中国健康常模比较，将术后3个月和6个月得分分别与术前基线水平进行比较。结果本组患者生理职能（RP）、一般健康状况（GH）、精力（VT）、社会功能（ SF）、情感职能（RE）、精神健康（MH）等6个维度术前得分低于中国健康常模（P <0.05），而生理机能（PF）、躯体疼痛（BP）2个维度与中国健康常模无明显差异。PF 和 BP 术后3个月较术前下降明显（P <0.05），术后6个月恢复至术前水平；RP、GH、SF和 RE 术后3个月与术前比较差异无统计学意义，术后6个月高于术前水平（P <0.05）；VT 术后3个月和6个月与术前比较均差异无统计学意义；MH 术后3个月和6个月均较术前明显改善（P <0.05）。结论局限性肾癌患者腹腔镜手术前及手术后早期 QoL 下降明显，而术后中晚期逐步恢复或接近正常水平，对于此类患者可及早给与心理干预、行为指导甚至药物治疗，改善患者 QoL。

Quality of life of patients undergoing laparoscopic surgery for localized renal cell carcinoma

Objective To evaluate and analyze the preoperative baseline and postoperative quality of life(QoL)of patients undergoing laparoscopic surgery for localized renal cell carcinoma. Methods A clinical study was prospec-tively accomplished in 49 patients with localized renal cell carcinoma undergoing laparoscopic surgery. The QoL scores were evaluated with the 36-item Short-Form Health Survey(SF-36)questionnaire(Chinese version)in 1 day preoperatively and 3,6 months postoperatively. The preoperative baseline QoL scores were compared with norm for the Chinese population,and 3,6 months postoperative QoL scores were compared with preoperative baseline lev-el respectively. Results The scores of role-physical(RP),general health(GH),vitality(VT),social functio-ning(SF),role-emotional(RE)and mental health(MH)of our sample were lower compared with norm for the Chinese population(P < 0. 05),but there was no significant difference between our sample and Chinese norm in the scores of physical function(PF)and body pain(BP). The scores of PF and BP were decreased significantly 3 months postoperative(P < 0. 05),and returned to the preoperative baseline level in 6 months postoperative. There was no significant difference in the scores of RP,GH,SF and RE between 3 months postoperative and preoperative baseline level,but it was improved significantly 3 months later(P < 0. 05). There was also no significant difference in the scores of VT between 3,6 months postoperative and preoperative level. It was improved significantly in both 3 and 6 months postoperative compared with preoperative baseline in MH(P < 0. 05). Conclusion The QoL of patients with localized renal cell carcinoma is impaired in preoperative and early postoperative period,and gradually returns to or near to normal in later. So,it is necessary to give psychological intervention,behavioral guidance or medication to those patients as early as possible to improve their QoL.