晚期妇科恶性肿瘤患者综合治疗后生活质量评价

Effectiveness evaluation of comprehensive treatment on gynecology terminal cancer patients

目的评价综合治疗对晚期妇科恶性肿瘤患者的生活质量、心理状况和社会关系改善的效果。方法对2010年1月至2011年10月北京市第二医院妇科收治的60例晚期妇科恶性肿瘤患者行对症躯体支持治疗+个体化心理抚慰干预综合治疗,采用生存质量量表[EORTC QLQ-C30(V3.0)]、多伦多述情障碍量表(TAS-20)、贝克抑郁问卷(BDI)、贝克焦虑量表(BAI)、非理性信念量表(IBS)和数字疼痛强度量表(NRS)对患者的生活质量、焦虑和抑郁情绪等进行评估。结果治疗后患者的躯体功能、情绪功能、认知功能、社会功能的评分均有升高(P<0.05);疲劳、疼痛、恶心呕吐3个主要症状均明显改善(P<0.05);6个单一条目中的呼吸困难、失眠、食欲丧失和便秘状况明显改善(P<0.05);腹泻和经济困难评分虽然下降,但差异均无统计学意义(P>0.05)。治疗后焦虑、抑郁和绝望患者有所减少,接受现状者明显增加(P<0.05)。治疗后TAS-20、BDI、BAI、IBS和NRS的评分值均有下降(P<0.05)。治疗后疼痛缓解率为84.62%(44/52),治疗后疼痛率(66.67%,38/57)与治疗前(91.23%,52/57)比较,差异有统计学意义(P<0.01)。结论综合治疗可明显减轻晚期妇科恶性肿瘤患者的症状,改变患者对死亡的恐惧感和错误认知,提高其生活质量。

Objective To assess the effect of comprehensive treatment on improving life quality,status of psychology and social relation of gynecology terminal cancer patients.Methods 60patients with gynecology terminal cancers received comprehensive treatment（supportive treatment on body symptom and individual psycho-concili-atory intervention）from January,2010to October,2011.The quality of life,the sence of anxiety and depression, the degree of social support of patients were assessed before and after one month of therapy.Results All the scores of physical function,emotional function,cognitive function and social function increased following the treatment（P 〈0.05）.Three main symptoms of fatigue,pain,nausea and vomiting were all significantly improved.Six single entries of dyspnoea,insomnia,appetite loss and constipation were significantly decreased,which meant these symp-toms improved.The scores of diarrheas and economic difficulties were decreased but had no significant difference（P 〉0.05）.The number of patients with anxiety or depression or desperation was decreased while the number of acceptable patients was increased after treating （P〈0.05）.Compare to pre-treatment,the total scores of TAS-20, BDI,BAI,IBS and NRS were significantly lower post treatment（P〈0.05）.The total relief rate of pain was 84.62% （44/52）.After treatment,the rate of pain dropped to 66.67% （38/57）and was significantly different compare to pro-treatment（P〈0.01）.Conclusion Comprehensive treatment could obviously reduce the symptoms of gynecology terminal cancer patients,improve their life quality,thus has significant clinical value.