乳腺癌患者保乳治疗选择的社会心理因素分析

Factors that influencing patients' decision making for breast conserving surgery

目的乳腺癌的保乳手术治疗已成为早期乳腺癌治疗的标准方式之一,本研究旨在调查适合保乳治疗的患者选择手术方式的有关社会心理因素。方法对本科收治的115例临床拟诊乳腺癌、具有保乳指征的患者在术前进行问卷调查,单因素和多因素分析比较选择保乳和不保乳者在临床特征及社会心理因素上的差异。结果患者本人有职业（OR=17.975,95%CI：1.750～184.571,P=0.015）、患者本人意愿（OR=0.015,95%CI：0.002～0.101,P=0.000）、配偶建议（OR=0.251,95%CI：0.068～0.926,P=0.038）和患者对保乳治疗疗效的态度（OR=0.157,95%CI：0.025～0.989,P=0.049）是最终选择保乳手术的独立影响因素。结论保乳手术时应考虑患者不同临床特征和社会心理因素的影响,在临床上可对适合保乳的患者及其配偶进行针对性的知识宣教,可能有助于提高保乳治疗率。

Objective Breast conserving surgery （BCS） has become a standard therapy for early breast cancer patients. This study investigated the relationship between the treatment choice and the social and psychological factors of the patients who were fit for BCS. Methods One hundred and fifteen patients diagnosed as breast cancer in our department were interviewed using a questionnaire. The related factors were compared between the two choice groups. Results Having jobs （OR = 17. 975,95%CI：1.750- 184. 571,P=0.015）, patient＇s wish（OR =0.015,95%CI：0.002-0. 101, P = 0. 000）, husband＇s suggestion （OR = 0. 251,95%CI：0. 068 - 0. 926, P = 0. 038） and the patient＇s attitude to BCS （OR = 0. 157,95%CI：0. 025 - 0. 989, P = 0. 049） were all independent factors influencing the patient＇s decision making for BCS. Conclusions We should include the patients＇ characteristics and social and psychological factors into consideration when performing BCS. Appropriately introducing the knowledge about BCS to patients and their husbands may help improving the rate of BCS .