周　元，顾则娟，蒋秀美，魏兴玲



初诊急性白血病病人入院前后相关并发症及生活质量的动态变化研究

周元，顾则娟，蒋秀美，魏兴玲

摘要：[目的]探讨初诊急性白血病病人入院前后相关并发症及生活质量的动态变化。[方法]采用便利抽样法对50例初诊急性白血病病人进行问卷调查，调查工具包括癌症病人生活质量测定量表(EORTC QLQ -C30)、医院焦虑抑郁量表、身体功能状态量表(KPS)、癌症疲乏量表(CFS)、改良Barthel指数量表(MBI)等，分析入院前后相关并发症及生活质量的动态变化。[结果]初诊急性白血病病人KPS评分为(57.40±11.38)分，Barthel指数(71.10±16.04)分，QOL总体健康水平(55.61±19.12)分，身体功能状态、自理能力、癌症疲乏、焦虑、抑郁等在入院前1周、化疗期间、骨髓抑制期3个阶段均存在差异。[结论]初诊急性白血病病人身体功能状态、焦虑、抑郁症状、生活质量较差，且在3个阶段呈现一定变化趋势，提示护理人员应重视初诊急性白血病病人护理需求的变化，根据病人不同阶段的特点，合理干预，提高病人的生活质量。

关键词：急性白血病；生活质量；并发症；焦虑；抑郁；疲乏；自理能力；动态变化

Study on dynamic changes of related complications and quality of life of patients with firstly diagnosed acute leukemia before and after admission

Zhou Yuan，Gu Zejuan，Jiang Xiumei，et al

(College of Nursing，Nanjing Medical University,Jiangsu 210029 China)

AbstractObjective:To probe into the dynamic changes of related complications and quality of life of patients with firstly diagnosed acute leukemia before and after admission.Methods:A total of 50 acute leukemia patients receiving firstly diagnosed were selected by using convenience sampling method.Instruments used in the research included Cancer patients quality of life measurement scale(C30 EORTCQLQ)，hospital anxiety and depression scale，body function state scale(KPS)，cancer fatigue scale(CFS)，modified Barthel index scale (MBI)，etc.Results: The mean score of KPS was 57.40±11.38;Barthel ratio was 71.10±16.04;Total health level of QOL was 55.61±19.12.There were statistically significant differences in body function，self-care ability，cancer fatigue，anxiety，depression and so on at 1 week before admission，during chemotherapy and during bone marrow suppression.Conclusion:Firstly diagnosed acute leukemia patient was poor in body functional status，anxiety，depression，quality of life，and in the three stages they showed a certain variation trend,so it suggested that nursing staff should pay attention to changes in newly diagnosed acute leukemia patients’ care needs，according to the characteristics of the patients at different stages，reasonable intervention，to improve the quality of life of the patients.

Key wordsacute leukemia；quality of life；complications；anxiety；depression；fatigue；self-care ability；dynamic changes

急性白血病(acute leukemia,AL)是一种造血干细胞的恶性克隆性疾病。世界范围内，每年约有25万人诊断为白血病，占所有癌症病人的25%[1]，我国以每年约4万例的速度迅速增长[2]。美国食品与药品协会(FDA)提出，对肿瘤的治疗必须从存活率的提高和生活质量的改善两方面来评价。现有研究发现，AL病人生活质量低于正常人群[3]，且其下降主要表现在生理、心理、角色和社会功能等方面[4]。……