腹腔镜广泛性子宫切除术联合盆腔淋巴结清扫术对宫颈癌患者生存质量的影响及其相关因素分析

Influence and related factors of laparoscopic radical hysterectomy combined with pelvic lymphadenectomy on the quality of life of cervical cancer patients

目的探讨腹腔镜广泛性子宫切除术联合盆腔淋巴结清扫术对宫颈癌患者生存质量的影响及其相关因素。方法选取2018年3月至2019年7月于苏州市立医院行腹腔镜广泛性子宫切除术联合盆腔淋巴结清扫术的96例宫颈癌患者为研究对象,采用世界卫生组织生存质量测定量表简表(World Health Organization quality of life BREF,WHOQOL-BREF)评估患者术后生存质量,并分析影响患者术后生存质量的相关因素。结果96例宫颈癌患者术后3个月WHOQOL-BREF生理领域、环境状况领域评分和总分均显著高于术后2周(均P<0.05),而术后3个月和术后2周患者心理领域和社会关系领域评分比较差异均无统计学意义(均P>0.05)。年龄<40岁、大专及以上文化程度、与家人同住、家庭平均月收入>4000元、肿瘤分期Ⅰa期、肿瘤分化程度G1级、手术时间<3 h、无术后并发症、术后放疗或化疗、高希望水平的宫颈癌患者术后3个月WHOQOL-BREF总分均显著高于年龄>60岁、小学及初中文化程度、独居、家庭平均月收入<2000元、肿瘤分期Ⅱa期、肿瘤分化程度G3级、手术时间≥3 h、有术后并发症、未接受术后放疗或化疗、低希望水平者(均P<0.05)。家庭平均月收入、肿瘤分期、Herth希望指数评分均为行腹腔镜广泛性子宫切除术联合淋巴清扫术的宫颈癌患者术后3个月生存质量的独立影响因素(均P<0.05)。结论行腹腔镜广泛性子宫切除术联合盆腔淋巴结清扫术的宫颈癌患者术后短期内生存质量较低,这与患者家庭平均月收入、肿瘤分期、希望水平有关。

Objective To analyze the influence and related factors of laparoscopic radical hysterectomy combined with pelvic lymph adenectomy on the quality of life of cervical cancer patients.Method Ninety-six patients with cervical cancer who underwent laparoscopic radical hysterectomy combined with pelvic lymphadenectomy in Suzhou Municipal Hospital from March 2018 to July 2019 were enrolled for the study.The World Health Organization quality of life BREF questionnaire(WHOQOL-BREF)was used to analyze the changes of patients'postoperative quality of life,and analyzed the related factors affecting the postoperative quality of life of patients.Result The physiological status,environmental status score and total score of 96 patients with cervical cancer at 3 months after operation were significantly higher than those at 2 weeks after operation(all P<0.05),but there were no significant differences in psychological status and social relationship scores between 3 months after operation and 2 weeks after operation(all P>0.05).The WHOQOL-BREF total scores 3 months after operation of cervical cancer patients aged<40 years old,college education or above,living with family,average monthly income of family>4000 yuan,tumor stageⅠa,degree of differentiation G1,operation time<3 h,no postoperative complications,postoperative radiotherapy or chemotherapy,high hope level were significantly higher than those of patients aged>60 years old,primary school and junior high school education,living alone,average monthly family income of family<2000 yuan,tumor stageⅡa,degree of differentiation G3,operation time≥3 h,postoperative complications,no postoperative radiotherapy or chemotherapy,low hope level(all P<0.05).Average monthly family income,tumor stage and Herth hope index score were independent factors affecting the quality of life of cervical cancer patients with laparoscopic radical hysterectomy combined with pelvic lymphadenectomy(all P<0.05).Conclusion The short-term quality of life of cervical cancer patients after laparoscopic radical hysterectomy combined with pelvic lymphadenectomy is low and significantly related to the average monthly income of the family,tumor stage and hope level.