乳腺癌术后上肢淋巴水肿患者生活质量现状及影响因素分析

Analysis of quality of life status and its influencing factors of patients with upper limb lymphedema after breast cancer operation

目的探讨乳腺癌术后上肢淋巴水肿患者的生活质量现状及影响因素。方法选取2018年11月~2019年7月衡阳市某三级甲等医院乳甲外科和淋巴水肿门诊就诊的189例乳腺癌术后患者作为研究对象,其中上肢淋巴水肿者作为ULL组(41例),无上肢淋巴水肿者作为N-ULL组(148例)。采用中文版上肢淋巴水肿生活质量量表(ULLQoL)和乳腺癌患者生命质量测定量表(FACT-B),调查两组患者的生活质量,探讨影响乳腺癌术后上肢淋巴水肿患者生活质量的因素。结果在FACT-B中,ULL组患者的功能状况评分低于N-ULL组,差异有统计学意义(P<0.05);ULL组和N-ULL组患者的FACT-B总分及其余各维度评分比较,差异均无统计学意义(P>0.05)。在ULLQoL中,ULL组患者的躯体维度、心理维度评分及ULLQoL总分均高于N-ULL组,差异有统计学意义(P<0.05)。单因素分析结果显示,不同文化程度、优势侧、化疗情况的乳腺癌相关淋巴水肿(BCRL)患者的ULLQoL评分比较,差异有统计学意义(P<0.05)。多元逐步回归分析结果显示,优势侧、化疗中是BCRL患者生活质量的影响因素(P<0.05)。结论术后并发上肢淋巴水肿的乳腺癌患者的生活质量低于无淋巴水肿患者。优势侧、化疗中是影响乳腺癌术后上肢淋巴水肿患者生活质量的主要因素,ULLQoL更能细微地反映上肢淋巴水肿对乳腺癌患者生活质量的影响。

Objective To explore the quality of life(QoL)status of patients with upper limb lymphedema after breast cancer operation and its influencing factors.Methods A total of 189 patients who underwent breast cancer surgery treated in department of surgery and lymphedema in a third class A hospital of Hengyang City from November 2018 to July 2019 were selected as the subjects.The patients with upper limb lymphedem were in the ULL group(41 cases),and those without upper limb lymphedem were in the N-ULL group(148 cases).Both groups received two questionnaires includes the Chinese version of the upper limb lymphedema quality of life questionnaire(ULLQoL)and the Chinese version of the functional assessment of cancer therapy-breast(FACT-B)in order to compare the QoL between two groups and the influencing factors of QoL among BCRL patients were explored.Results In the FACT-B,the functional score of the patients in the ULL group was lower than that in the N-ULL group,the difference was statistically significant(P<0.05).There was no significant difference in the total score of FACT-B and the other dimensions between group ULL and N-ULL group(P>0.05).In the ULLQoL,the scores of physical dimension,psychological dimension and the total ULLQoL scores of the patients in the ULL group were higher than those in the N-ULL group,and the differences were statistically significant(P<0.05).The results of univariate analysis showed that there was a significant difference in ULLQoL scores among breast cancer-related lymphedema(BCRL)patients with different education,dominant side and chemotherapy(P<0.05).Multiple stepwise regression analysis showed that the dominant side and chemotherapy were the influencing factors of BCRL patients′QoL(P<0.05).Conclusion Affected by various factors,the QoL in BCRL patients is relatively poor,among which dominant side and chemotherapy are mainly influence factors.In addition,the C-ULLQoL is a more specific tool for assessing QoL in patients with BCRL.