乳腺癌术后乳房再造患者满意度和生活质量相关性分析

Correlation analysis of satisfaction and quality of life in patients with breast reconstruction after mastectomy

目的探讨乳腺癌术后乳房再造患者的满意度和生活质量的相关性,并分析满意度的影响因素。方法以2016年1月至2019年6月在湖南省肿瘤医院就诊的乳腺癌术后乳房再造女性患者为研究对象,使用乳房再造满意度问卷(BRECON-31)及乳腺癌生活质量测定量表(QLQ-BR23)对其进行问卷调查,并收集患者临床资料及人口社会学资料,采用皮尔森相关分析进行满意度和生活质量之间的相关性检验,单因素分析及多重线性回归分析满意度的影响因素。结果最终纳入157例患者,均为女性,年龄为(41.8±8.3)岁,中位随访时间为11个月。共发放问卷157份,回收有效问卷147份。乳腺癌术后乳房再造患者满意度较高,其总分为(74.44±6.29)分。乳房再造患者亲密关系与身体形象(r=-0.183、P=0.043)、性功能(r=0.201、P=0.026)、性乐趣(r=0.204、P=0.029)、乳房症状(r=-0.247、P=0.006)及手臂症状(r=-0.246、P=0.006)存在着相关关系,患者的自我意识受到身体形象(r=-0.228、P=0.006)、性功能(r=-0.293、P<0.001)、性乐趣(r=-0.258、P=0.003)、乳房症状(r=-0.183、P=0.029)、脱发烦恼(r=-0.187、P=0.027)等因素的影响。单因素分析结果显示,年龄(P=0.047)、肿瘤分期(P=0.004)、再造方式(P<0.001)、是否放化疗(P=0.043)是满意度总分的影响因子。多重线性回归结果显示,再造方式(P<0.001)是满意度总分的独立影响因子,单纯自体组织再造的满意度总分为(75.99±5.94)分,要优于自体组织联合假体的(71.08±4.99)分和单纯假体置入的(70.81±8.54)分。结论乳腺癌术后乳房再造患者的生活质量与满意度相互影响。年龄、肿瘤分期、再造方式、是否放化疗是满意度总分的影响因子,其中再造方式是独立影响因子,单纯自体组织乳房再造可优先选择。

Objective To investigate the relationship between satisfaction and quality of life of patients with breast reconstruction after mastectomy,and analyze the influencing factors of satisfaction.Methods In this study,157 female breast reconstruction patients who were treated in Hunan Cancer Hospital from January 2016 to June 2019 were selected as the object of this study.The BRECON-31 and QLQ-BR23 were used to assess satisfaction and quality of life respectively,and the clinical and demographic data were collected,Pearson correlation test was applied to analyze the correlation between satisfaction and quality of life,univariate analysis and multiple linear regression analysis were performed to investigate the influence factors of satisfaction.Results A total of 157 patients,whose age was(41.8±8.3)years and median follow-up time was 11 months were included and 147 valid questionnaires were collected.The satisfaction score was 74.44±6.29,which meant patients with breast reconstruction after mastectomy had high satisfaction.There was a significant correlation between intimacy and body image(r=-0.183,P=0.043),sexual function(r=0.201,P=0.026),sexual interest(r=0.204,P=0.029),breast symptoms(r=-0.247,P=0.006)and arm symptoms(r=-0.246,P=0.006)in patients with breast reconstruction after mastectomy,the patient’s self-awareness was significantly influenced by factors such as body shape(r=-0.228,P=0.006),sexual function(r=-0.293,P<0.001),sexual interest(r=-0.258,P=0.003),breast symptoms(r=-0.183,P=0.029),hair loss-induced annoyance(r=-0.187,P=0.027).The result of univariate analysis showed that age(P=0.047),tumor stage(P=0.004),reconstruction method(P<0.001),chemoradiotherapy(P=0.043)were the influencing factors of total satisfaction score,multiple linear regression result showed that the reconstruction method(P<0.001)was an independent influence factor of satisfaction score.The total satisfaction score of patients with autologous tissue reconstruction(75.99±5.94)was better than that of patients with autologous tissue combined prosthesis(71.08±4.99)and patients with simple prosthesis implantation(70.81±8.54).Conclusions Mutual impact was identified for life quality and satisfaction among patients with breast reconstruction after mastectomy.In addition,age,tumor stage,reconstruction method and chemoradiotherapy are the influence factor of satisfaction.Among them,the reconstruction method is independent influence factor,and the breast reconstruction with autologous tissue is a better choice.