造血重建对异基因造血干细胞移植患者早期生活质量的影响

Impact of hematopoietic reconstruction on early quality of life of patients after allogeneic hematopoietic stem cell transplantation

目的探讨造血重建对异基因造血干细胞移植(HSCT)患者早期生活质量的影响,为针对性干预提供参考。方法将122例患者以出净化病房时血小板是否重建分为造血重建组(88例)和造血延迟组(34例),采用癌症治疗功能评价系统-骨髓移植生命质量测评量表(FACT-BMT)测评患者在入净化病房前、移植后1、3、6个月生活质量。结果 122例患者不同时间点生活质量得分差异有统计学意义,其中移植后1个月得分最低,6个月时得到显著改善(P<0.05,P<0.01);造血重建组前3个时间点生活质量得分显著高于造血延迟组(均P<0.05)。多元回归分析结果显示早期造血重建与否是HSCT患者生活质量的主要影响因素,其次为移植物抗缩主病及性别(均P<0.05)。结论早期造血重建可作为HSCT患者术后生活质量的预测因素,护理人员应特别注重对造血延迟患者的针对性护理,以助HSCT患者在术后早期获得较好的生活质量。

Objective To investigate the effect of hematopoietic reconstruction on early quality of life of patients receiving allogeneic hematopoietic stem cell transplantation（allo-HSCT）,and to provide evidence for targeted interventions.Methods A total of 122 patients after allo-HSCT were divided into a reconstruction group（n=88）and a delayed reconstruction group（n=34）accor-ding to whether platelet reconstruction was built when patients were transferred out of the purification ward.The Functional Assessment of Cancer Therapy-Bone Marrow Transplantation scale（FACT-BMT）was used to evaluate patients′quality of life before transfer to purification ward and 1,3,and 6 months post transplantation.Results Quality of life of the 122 patients had statistical difference at different time points,showing significant decrease at 1 month post transplantation and significant increase at 6 months post transplantation（P〈0.05,P〈0.01）.Quality of life at the former 3 time points in the reconstruction group was significantly higher than the delayed reconstruction group（P〈0.05 for all）.Multivariate regression analysis showed that early hematopoietic reconstruction was the main factor influencing quality of life in patients receiving allo-HSCT,followed by development of graft versushost disease and age（P〈0.05 for all）.Conclusion Early hematopoietic reconstruction was a significant predictor of quality of life after allo-HSCT,and attention should be paid to those who had delayed platelet reconstruction,thus to provide targeted intervention for improving their quality of life.