内行患者计划对直肠癌患者 Miles 术后早期生活质量及造口适应水平的影响

Effects of expert patient program on early quality of life and adaptation in rectal cancer patients after Miles surgery

目的：评价内行患者计划对直肠癌患者 Miles 术后早期生活质量及造口适应水平的影响。方法选择2013年2月—2014年7月直肠癌 Miles 术后患者103例,采用随机数字表法分为干预组52例和对照组51例。干预组参加为期2个月的内行患者计划培训课程,对照组进行常规门诊随访。干预后2个月,采用欧洲癌症研究与治疗组织生活质量测定量表（QLQ-C30）和造口适应量表（OAS）比较两组患者生活质量及造口适应水平变化。结果干预前两组患者生活质量各维度与造口适应水平得分比较差异均无统计学意义（P 〉0.05）,干预后除疲乏、呼吸困难、食欲减退症状条目外,干预组患者生活质量各维度得分均优于对照组,差异有统计学意义（t =-6.79~9.21,P 〈0.05）,且造口适应水平总分及各维度得分均高于对照组,差异有统计学意义（t =2.60~8.93,P 〈0.05）。结论实施内行患者计划可改善直肠癌患者 Miles 术后早期生活质量及造口适应水平。

Objective To evaluate the influence of expert patient program on early quality of life and adaptation in patients after Miles surgery. Methods A total of 103 patients after Miles surgery from February 2013 to July 2014 were selected and divided into intervention group （52 cases） and control group （51 cases） randomly by using random number table. The patients of intervention group participated in a two-month course of expert patient program, and the patients of control group received routine outpatient follow-up. Two groups of patients′ quality of life and adaptation were compared after intervention using QLQ-C30 and Ostomy Adjustment Scale （OAS） after two months intervention. Results Before intervention, each dimensions of quality of life and stoma adaptation had no statistical difference （ P 〉 0. 05）. Each dimensions of quality of life and stoma adaptation in the intervention group were better than those in the control group after two months course of expert patient program except the dimensions of fatigue, difficulty breathing and loss of appetite （t = - 6. 79 - 9. 21;P 〈 0. 05）;scores of total stoma adaptation and its each dimensions of the intervention group were higher than those of the control group （t = 2. 60 - 8. 93;P 〈 0. 05）. Conclusions The implementation of expert patient program can significantly improve quality of life and adaptation level in patients after Miles surgery.