直肠癌Miles术后结肠造口患者生活质量及影响因素研究

目的了解淮南市直肠癌结肠造口患者的生活质量现状及其影响因素,为提高永久性结肠造口患者的生活质量提供依据。方法使用欧洲癌症研究与治疗组织生活质量核心问卷对120例在淮南市3所二级甲等医院行直肠癌结肠造口患者的生活质量进行问卷调查,将所得资料进行统计学分析。结果结肠造口患者总体生活质量得分为60.4±22.8分,角色功能和社会功能得分显著低于常模(P<0.01),腹泻和经济困难得分显著高于常模(P<0.01)。相关分析结果显示,心理状态和造口并发症是影响总体生活质量及各功能维度的主要因素;多元逐步回归分析结果显示,心理状态、术后时间、造口并发症是进入回归方程的因素,心理状态、术后时间与生活质量呈正相关,造口并发症与生活质量呈负相关。结论结肠造口患者角色功能和社会功能显著受影响,腹泻症状和经济困难严重。造口专科护士应为患者提供精神心理支持,训练患者规律排便,采取多种方式重点指导患者正确认识、预防、处理造口并发症,以改善其生活质量。

Investigation on Life Quality of Patients with Rectal Cancer Undergoing Colostomy and Influencing Factors

Objective To understand the quality of life （QOL）of colostomy patients with rectal cancer and explore its influencing factors, to provide evidences for improving the QOL of permanent colostomy patients. Methods Survey 120 colostomy patients with rectal cancer with EORTC-QLQ-C30 and collect the data for statistical analysis. Results The score of QOL of colostomy patients was 60. 4±22. 8 and the scores of role function and social function were significantly lower than those of the norm （P〈0. 01）. Besides, the scores of diarrhea and economic difficulties were significantly higher than those of the norm （P〈0. 01）. Correlation analysis showed that the psychological condition and stoma complications were the main factors that affected the QOL of colostomy patients and multiple stepwise regression analysis indicated the psychological condition, postoperative time, complication entered into the regression equation of QOL. The psychological condition and postoperative time were positively correlated with the QOL, while the stoma Complication was negatively correlated with the QOL. Conclusion The role function and social function of colostomy patients are significantly affected, and the diarrhea symptom and economic difficulties are severe. To improve the QOL of colostomy patients, specialized nurses for stoma should provide psychological support for patients and help to train patients with regular bowel movement so as to prevent and treat stoma complications through various ways.