保乳切除术对乳腺癌患者生活质量及心理状态的影响

Effect of different breast cancer surgery methods on quality of life and psychological states among breast cancer patients after operation

目的探讨乳腺癌手术方式的不同对患者术后生活质量及心理状况的影响。方法收集2015-01—2017-06郑州大学附属肿瘤医院确诊的280例乳腺癌患者的临床资料,按照手术方式分为保留乳房乳腺癌切除术(保乳手术组)及乳腺癌改良根治术组(改良根治术组),对患者术前及术后1 a的生活质量及心理情况进行调查。采用乳腺癌生命质量测评表FACT-B(functional assessment of cancer therapy-breast)、Rosenberg自尊量表(Rosenberg self-esteem scale,RSES)、汉密尔顿焦虑量表(Hamilton anxiety rating scale,HAMA)及汉密尔顿抑郁量表(Hamilton depression rating scale,HAMD)分别对患者的生活质量、自尊心和心理状况进行评定。结果术前保乳手术组和改良根治术组患者的生命质量、自尊、焦虑及抑郁评分差异无统计学意义(P>0.05)。术后1 a保乳手术组患者的生活质量、自尊、焦虑及抑郁评分显著优于改良根治术组,差异有统计学意义(P<0.001)。结论保乳切除术相较于改良根治术对乳腺癌患者远期生活质量及负面情绪有显著改善,并可明显提高患者自信心,在可选择的情况下保乳切除手术值得推广。

Objective To explore whether quality of life and psychological situation among breast cancer patient are influenced by distinct operation options.Methods Clinical data of 280 patients with breast cancer diagnosed in our hospital from January 2015 to June 2017 were collected.The quality of life,self-esteem and psychological status of the patients before and one year after operation were investigated by questionnaires return visit.Breast cancer life quality evaluation table FACT-B(functional assessment of cancer therapy-breast),Rosenberg self-esteem scale(RSES),Hamilton anxiety rating scale(HAMA)and Hamilton depression rating scale(HAMD)were used to assess patients’quality of life,self-esteem and psychological status separately.Results The scores of quality of life,self-esteem,anxiety and depression were similar in the two groups(breast-conserving surgery group and modified radical mastectomy group)before surgery,and the differences were not statistically significant(P>0.05).One year after operation,the scores of quality of life,self-esteem,anxiety and depression in breast-conserving surgery group were significantly better than those in modified radical mastectomy group,and the differences in scores for each scale were statistically significant(P<0.001).Conclusion Compared with modified radical mastectomy group,the long-term quality of life,self-esteem and negative emotions of patients have been significantly improved in breast-conserving surgery group.Therefore,the breast-conserving surgery is worthy of further generalization under optional circumstances.