手术去势对晚期前列腺癌患者生活质量的影响

The quality of life in man after treatment of advanced prostate cancer by surgical castration

目的 调查手术去势对晚期前列腺癌患者生活质量的影响。方法 采用EORTC QLQ-C30总量表和QLQ—PR25子量表调查69例接受手术去势的晚期前列腺癌患者患病前、治疗后6个月和治疗后12个月3个时间点的生活质量情况。结果 手术去势虽然能缓解全身或局部疼痛（P〈0．01），并改善排尿症状（P〈0．01），且患者感觉总体健康状况有好转（P〈0．01），但术后患者躯体（P〈0．05）、角色（P〈0．01）、情绪（P〈0．01）、认知（P〈0．05）、社会（P〈0．05或〈0．01）等功能均有不同程度下降，且失眠增多（P〈0．05）、疲倦加剧（P〈0．01），治疗相关症状如潮红与乳房胀痛等显著出现（．P〈0．01），性趣明显下降甚至丧失（P〈0．01），特别是彻底丧失了正常的性生活。结论 手术去势对前列腺癌患者的机体与心理均有不同程度的影响，尤其是性功能方面有不可逆性损害。

Objective To investigate the quality of life in man after treatment of advanced prostate cancer by surgical castration. Methods A total of 69 patients with advanced prostate cancer treated by surgical castration completed the European organization for research and treatment of cancer quality of life questionnaire （QLQ-C30） and QLQ-prostate specific 25-item （PR25） module third at a 12-month interval. The assessment points were preoperative,6 months postoperative and 12 months postoperative. Results Although there were improvement on pain relief （P 〈 0.01 ） and symptom of urinary （P 〈 0.01 ） and global health （P 〈 0.01 ）, the physical functioning （P 〈 0.05）, role functioning （P 〈 0.01 ） ,emotional functioning （P 〈 0.01 ）, cognitive functioning （P 〈 0.05）, social functioning （P 〈 0.05 or 〈 0.01 ） were found significantly reduced, and insomnia （P 〈 0.05） and fatigue （P 〈 0.01） aggravated, treatment related symptoms （P 〈 0.01 ）appeared predominantly, especially deprivation of sexual functioning. Conclusion The surgical castration when treating advanced prostate cancer did appear to impair the physical and psychological of patients, especially the sexual functioning.