结直肠癌术后病人生存质量现状及影响因素分析

Status and influencing factors of quality of life in patients with colorectal cancer

目的探讨结直肠癌术后病人生存质量,分析不同因素对生存质量的影响,以利于采取针对性的干预措施。方法对2012年2月至2017年6月在我院收治的246例结直肠癌术后病人进行回顾性分析及生存质量的问卷调查,应用线性回归分析,筛选结直肠癌术后病人生活质量的影响因素。结果 246例结直肠癌术后病人各功能领域及总体生存状态评分均较低,60岁以上病人躯体功能、认知功能、得分均低于45岁以下组及45~60岁组,症状领域高于45岁以下组及45~60岁组。性别、年龄、文化程度、经济状况、医保类型及手术方式对于生存质量各维度的影响较大。影响躯体功能的主要因素是年龄、医保类型;影响角色功能的主要因素是文化程度、经济状况、医保类型;影响认知功能的主要因素是年龄、文化程度、经济状况、手术方式;影响情绪功能的主要因素是年龄、文化程度、经济状况;影响社会功能的主要因素是性别、生存时间及疾病预后告知情况;影响症状领域的主要因素是年龄、手术方式;影响单项症状的主要因素是性别及手术方式;影响整体生命质量的主要因素是年龄、经济状况。结论不同因素影响结直肠癌术后病人不同领域,临床上应采取综合性措施以改善病人的生存质量。

Objective To investigate the quality of life（ QOL） and the influencing factors in patients after colorectal cancer operation,so as to establish effective measures to improve their life quality. Methods A total of 246 postoperative patients with colorectal cancer in Nanjing First Hospital during the periods from February 2012 to June 2017 were enrolled in the study. The cases were surveyed by trained interviewers with constructed questionnaires. The multiple linear regression method was used to analyze the factors influencing QOL of the patients. Results All postoperative patients with colorectal cancer had low scores in functional scales,symptom scales and a global health and QOL scale. The scores of functional scales including physical function and cognitive function in ≥60 age group were significantly lower than those of ≤45 age group and 45 ～ 60 group,while the scores of symptom scoles were higher than them. Sex,age,education level,economic status,type of medical insurance,operation method were important influencing factors. The main factors that affect physical function were age and medical insurance type. The main factors that influence the function of the characters were education level,economic situation and the type of medical insurance. The main factors that affect cognitive function were age,education level,economic condition and surgical method. The main factors that affected emotional function were age,education level and economic status. The main factors that affect social function were gender,survival time and prognosis of disease. The main factors affecting the symptom area were age and surgical method. The main factors that affect individual symptoms were gender and surgical approach. The main factors that affect the overall QOL were age and economic condition. Conclusions Different factors affect different areas,so we should take comprehensive measures to improve the QOL of patients receiving colorectal cancer operation.