综合康复干预对恶性肿瘤患者生存质量的影响

The effect of comprehensive intervention on the quality of life of cancer patients

目的研究肿瘤学、心理学和社会医学相结合的多学科综合康复干预措施对恶性肿瘤患者生存质量(QOL)的影响。方法639例恶性肿瘤患者分为干预组和对照组,干预组在专家指导下进行综合健康干预,干预期为2年,对照组则不参加综合康复干预。干预组随访254例,对照组随访330例。干预前、后用根据欧洲癌症研究和治疗协会所拟的生存质量核心问卷改进的QOL评定量表对患者的QOL进行评定。结果干预组经综合康复干预后,各维度评分和总分均明显高于对照组(P＜0．05)。干预前、后2组差值比较,干预组的心理状态、家庭社会功能及自我评价3个维度评分差值分别为(5．91±5．46)分、(1．97±3．79)分和(1．95±1．69)分,总分差值为(15．25±10.97)分,与对照组比较差异均有统计学意义(P＜0．05)；在控制了年龄、收入、职业和治疗方法等不均衡因素后,干预组上述3个维度差值的预测值分别为(6．90±0．84)分、(2．00±0．56)分和(1．87±0．31)分,总分差值的预测值为(17．01±2．02)分,与对照组比较,差异仍有统计学意义(P＜0．05)。结论肿瘤学、心理学和社会医学多学科联合的综合康复干预有助于恶性肿瘤患者QOL的提高。

Objective To investigate the effectiveness of a combined intervention involving oncology, psychology and sociomedicine in improving the quality of life of patients with malignant tumours. Methods Six hundred and thirty-nine cancer patients were divided into an experimental group （272 people） and a control group （367 people）. Two hundred and fifty-four patients in the experimental group（93.98% ） and 330 patientsin the control group （89.91%） were successfully followed after the intervention,. The intervention involved systematic anti-cancer treatment directed by specialists, and mass anti-cancer measures. The experiment lastedfor 2 years. The life quality of the surviving patients was estimated using the modified European Organization for Research on Treatment of Cancer- Quality of Life Questionnaire-Core 30 （EORTC-QLQ-C30） before and after intervention. Results The dimensionality score of the experimental group was higher after intervention than that of the control group. After intervention, psychological status, familial and social role, and self evaluation were all significantly better in the experimental group than in the control group. The significant difference persisted after controlling for age, income, occupation and the means of treatment. Conclusion The comprehensive treatment protocol helped to improve the quality of life of patients with malignant tumour.