胃癌患者术后近期生活质量现状及相关因素分析

Short-term quality of life and related factors in patients with gastric cancer after operation

目的探讨胃癌患者行根治性切除术后近期生活质量及相关因素分析。方法选取2018年11月至2019年6月间中国医学科学院肿瘤医院收治的129例行胃癌根治手术治疗的患者,术前采用主观整体营养状况评估量表(PG-SGA)评估患者营养状态,围手术期实行标准术前、术后及出院护理流程,于术后3个月随访患者体质量及生活质量,并分析相关影响因素。结果患者围术期出现感染性并发症10例(7.8%),出血性并发症4例(3.1%),吻合口瘘3例(2.3%),胃肠功能障碍6例(4.6%)。患者术后3个月体质量较术前下降(8.21±4.98) kg,身体质量指数(BMI)下降(2.90±1.74) kg/m2,差异均有统计学意义(均P <0.05)。与远端胃癌根治术相比,行近端胃癌根治术和全胃切除术的患者体质量明显下降,生活质量评估中的总健康、疲倦、恶心呕吐、反流、进食受限和焦虑维度评分均降低,差异均有统计学意义(均P <0.05)。多元线性回归分析显示,术后患者BMI下降、焦虑领域和反流症状领域均有线性相关性,差异均有统计学意义(均P <0.05)。结论胃癌患者行根治性切除术后,近期体质量和生活质量下降明显,需营养指导和延续护理支持,必要时应医疗干预。

Objective To evaluate the short-term quality of life and its influencing factors in patients with gastric cancer undergoing radical gastrectomy. Methods This study recruited 129 patients with gastric cancer undergoing radical gastrectomy at Cancer Hospital,Chinese Academy of Medical Sciences between November 2018 and June 2019. Nutrition status was evaluated before surgery using scored patientgenerated subjective global assessment( PG-SGA). Standard perioperative nursing was provided based on the nursing pathway of the authors’ hospital. Patient’s body mass index( BMI) assssssssnd quality of life was followed-up at 3 months after the surgery and factors influencing them were analyzed. EORTC qlq-c30 and EORTC qlq-sto22 were used for quality of life assessment,and related factors were analyzed. Results Infectious complication occurred in 10 patients( 7. 8%). Bleeding complication occurred in 4 patients( 3. 1%). Anastomotic leak occurred in 3 patients( 2. 3%). Gastrointestinal dysfunction occurred in 6 patients( 4. 6%). Patients had a BMI loss of 8. 21 ± 4. 98 kg and BMI reduced by 2. 9 0 ± 1. 74 kg/m2 at 3 months after the surgery compared before the surgery( all P < 0. 05). Furthermore,patients undergoing proximal and total radical gastrectomy lost more weight than those undergoing distal radical gastric surgery.The assessment of quality of life found that total health,fatigue,nausea and vomiting,reflux,food intake disorder and anxiety significantly decreased( all P < 0. 05). Multiple linear regression analysis showed that there was a linear association in the BMI,anxiety and reflux aspects( all P < 0. 05). Conclusion Patients’ BMI and quality of life decrease significantly after radical gastrectomy and they need nutrition and knowledge support. Medical intervention should be given if necessary.