黄荣+曹亦军+陈腾+李梦帆+李炜+黄毅

摘 要 目的：探讨直肠癌手术患者的生活质量及其影响因素，为制定有效的措施改善其生活质量提供依据。方法：选取直肠癌术后患者92例，采用自制的调查问卷了解患者的一般情况，通过生存质量核心问卷（QLQ-C30）评价患者的生活质量。分析直肠癌手术患者生活质量影响因素和QLQ-C30量表功能模块的相关性，通过多元逐步回归分析了解影响直肠癌手术患者生活质量的主要因素。结果：直肠癌手术患者的角色功能、社会功能、疲倦、气促、食欲丧失得分显著低于常模，而腹泻、经济困难得分显著高于常模（P<0.05）。功能模块、总体生活质量和患者心理状态呈正相关而与造口并发症呈负相关（P<0.05）；造口术后时间和躯体功能、角色功能、社会功能、总体生活质量均呈正相关（P<0.05）。多元逐步回归分析结果显示，心理状态、造口并发症、造口术后时间是影响总体生活质量的主要因素。结论：临床上应加强心理疏导、健康宣教等改善患者的生活质量。

关键词 直肠癌 结肠造口术 生活质量 影响因素

中图分类号：R735.37 文献标识码：B 文章编号：1006-1533（2016）19-0054-04

Analysis of influencing factors and quality of life in 92 patients with rectal cancer operation

HUANG Rong*， CAO Yijun， CHEN Teng， LI Mengfan， LI Wei， HUANG Yi**（Putuo Hospital affiliated to Shanghai University of Traditional Chinese Medicine， Shanghai 200063， China）

ABSTRACT Objective： To investigate the life quality and the influencing factors in patients with rectal cancer operation so as to establish effective measures to improve their life quality. Methods： Ninety-two patients were selected after rectal cancer resection and their general conditions were understood by homemade questionnaire， and their life quality was assessed by the core questionnaire of European Organization for research and treatment of cancer （QLQ-C30）. The correlation between QLQ-C30 scale function modules and the factors affecting the quality of life in patients with rectal cancer operation was analyzed and the main factors affecting the quality of life of the patients were found by multiple stepwise regression analysis. Results： In the QLQ-C30 scale， the scores of role function， social function， fatigue， shortness of breath， appetite loss were significantly lower while the scores of diarrhea and economic difficulty were significantly higher in patients with rectal cancer operation than in the normal people（P<0.05）. The function module and the overall quality of life in patients have positive correlation with psychological status and negative correlation with complications （P<0.05）， and the time after colostomy is positively correlated with physical function， role function， social function， and the overall quality of life （P<0.05）. Multiple stepwise regression analysis showed psychological state， stoma complications and the time after colostomy were the main factors affecting the overall quality of life. Conclusion： Psychological counseling and health education should be strengthened for the improvement of the quality of life of patients.

KEY WORDS rectal cancer； colostomy； quality of life； influencing factors

直肠癌是消化系统的恶性肿瘤，发病率较高，近年来的流行病学研究显示，本病的发病率呈逐年上升的趋势，对患者的生活质量和身体健康构成严重的威胁[1]。随着现代医学的发展，在疾病早期通过手术清除病灶是治疗直肠癌的有效方式，但是由于多数病变位置较低，常常需要行永久性结肠造口术治疗[2]。患者术后排便习惯、身体结构的改变，可造成其生活质量的下降[3]。随着医学模式的转变，患者生活质量的改善情况受到了越来越多的重视。本文通过对直肠癌手术患者生活质量的调查，研究影响生活质量的因素，以帮助临床更好地改善患者生活质量，现报道如下。

1 资料与方法

1.1 一般资料

选取自2011年2月到2014年2月期间我院收治的直肠癌术后患者92例。……