自我管理教育对女性结直肠癌患者围手术期癌因性疲乏及生命质量的影响分析

Analysis on the effect of self-management education on perioperative cancer-related fatigue and quality of life in female patients with colorectal cancer

目的分析自我管理教育对女性结直肠癌患者围术期癌因性疲乏及生命质量的影响。方法选取2013年2月～2015年2月在我院行手术治疗的112例女性结直肠癌患者为研究对象,按照随机数字表法分为常规管理组(对照组)和自我管理教育组(观察组),各56例。观察术前2 d、术后2周时两组患者围手术期癌因性疲乏[围手术期疲劳测评量表(ICFS)]、心理弹性[Conner-Davidson心理弹性量表(CD-RISC)]差异;观察随访3年,比较两组患者术后3年生存情况(生存率、远处转移率、局部复发率)和生命质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-V3.0)]的差异。结果术后2周时,两组患者ICFS评分均较术前显著增高(P均<0.05),但观察组明显低于对照组(P<0.05);CD-RISC评分则较术前明显升高,且观察组显著高于对照组(P均<0.05)。术后随访3年,两组患者3年生存率、远处转移率均无明显差异(P均>0.05),但观察组局部复发率低于对照组(P<0.05);术后3年内两组患者EORTC QLQ-V3.0评分均逐年上升,且观察组均高于对照组(P均<0.05)。结论自我教育管理能有效减轻女性结直肠癌患者围术期癌因性疲乏,增加患者心理弹性;远期观察能降低患者3年内疾病局部复发率、提高生命质量。

Objective To analyze the effect of self-management education on perioperative cancer-related fatigue and quality of life in female patients with colorectal cancer. Methods A total of 112 female patients with colorectal cancer who underwent surgery in our hospital from February 2013 to February 2015 were selected as the study subjects. According to the random number table method, the patients were divided into the conventional management group （control group） and the self-management and education group （observation group）, with 56 cases in each group. The differences of perioperative cancer-related fatigue[perioperative fatigue assessment scale（ICFS）], and psychological resilience [Conner-Davidson Psychological Resilience Scale （CD-RISC）] were observed in both groups 2 d before surgery and 2 weeks after surgery; after 3 years of follow-up, the differences in the survival condition（survival rate, distant metastasis rate, local recurrence rate） after 3 years of surgery and quality of life[European Cancer Research and Treatment Organization Quality of Life Measurement Scale（EORTC QLQ-V3.0）] were compared between the two groups. Results At 2 weeks after surgery, the ICFS scores of the two groups were significantly higher than those before surgery（P〈0.05 for all）. However, the observation group was significantly lower than the control group（P〈0.05）; the CD-RISC score was significantly higher than that before surgery, and the observation group was significantly higher than the control group（P〈0.05 for all）. After 3 years of follow-up, there was no significant difference in 3-year survival rate and distant metastasis rate between the two groups（P〉0.05 for both）. However, the local recurrence rate in the observation group was lower than that in the control group（P〈0.05）; the EORTC QLQ-V3.0 scores in the two groups were increased year by year within 3 years after surgery, and the observation group was higher than the control group（P〈0.05 for all）. Conclusion Self-education and management can effectively alleviate cancer-related fatigue in female patients with colorectal cancer during perioperative period and increase their psychological resilience; long-term observation can reduce the 3-year local recurrence rate and improve the quality of life of patients.