生活质量评分表在肠代膀胱功能评估中的应用研究  

Feasibility of QOL score in functional assessment of orthotopic neobladder after radical cystectomy

作　　者：韩辉[1] 周芳坚[1] 王斌[1] 李永红[1] 秦自科[1] 刘卓炜[1] 陈晓峰[1] 

机构地区：[1]华南肿瘤学国家重点实验室中山大学肿瘤防治中心泌尿外科,广州510060

出　　处：《中华泌尿外科杂志》2008年第6期411-414,共4页Chinese Journal of Urology

基　　金：广东省医学科研基金项目（A2004220）

摘　　要：目的 探讨生活质量（QOL）评分表评估全膀胱切除肠代膀胱术后功能的可行性。方法对22例肠代膀胱术后患者进行问卷调查，重点了解日间及夜间排尿间隔、排尿时间、尿失禁发生程度，填写QOL评分表；患者均行常规尿动力学检测。分析QOL评分与排尿间隔、尿失禁程度及常见尿动力学参数间的相关性。结果22例患者QOL评分0～5分，平均2分；日间完全控尿19例，轻度尿失禁2例、中度尿失禁1例；夜间尿失禁12例，轻度4例、中度3例、重度5例；日间排尿间隔45～210min，平均136min。最大尿流率2．7～22．1ml／s，平均12．9ml／s；最大尿道闭合压33～114cmH2O（1cmH2O-0．098kPa），平均69．3cmH2O，剩余尿量5～300ml，平均91．8ml。QOL评分与尿失禁程度呈正相关（日间：r=0．510，P=0．015；夜间：r=0．911，P〈0．001），与日间排尿间隔呈负相关（r=-0．749，P〈0．001）；QOL评分的影响因素包括最大尿道闭合压、剩余尿量及最大尿流率。结论QOL评分可以作为评估肠代膀胱功能的量化指标，能较准确地反映患者实际控尿能力及生活质量的主观感受，且与常见尿动力学参数具有显著相关性。Objective To estimate the feasibility of QOL score in functional assessment of orthotopic neobladder after radical cystectomy. Methods Questionnaire survey, QOL score sheet and urodynamic examination were done in 22 patients with orthotopic neobladder. Investigations were focus on the micturition interval during daytime and nighttime. Micturition time, degree of incontinence and their relationship with QOL scores and urodynamic parameters were also analyzed. Results There were 3, 6, 7, 1, 2, 3 and 0 cases which QOL score were 0 to 6 accordingly. In the day time, 2 patients complained a light incontinence while 1 patient of moderate incontinence. In the nighttime, 3 patients had the complaint of moderate incontinence while 4 patients of light incontinence. The average daytime micturition interval was 136 min（45-210 min）. The average maximum urinary flow rate, maximal urethral closure pressure and postvoid residual were 12.9 ml/s（2.7-22. 1 ml/s）, 69.3 cm H2O （33-114 cm H20） and 91.8 ml （5-300 ml） respectively. QOL scores had positive correlation with the degree of incontinence during daytime and nighttime （daytime： r： 0. 510, P = 0. 015, nighttime：r= 0.911, P〈0. 001）. The QOL scores had negative correlation with daytime micturition inter val （r=-0. 749 ,P〈0. 001）. The factors which influenced the QOL scores included the maximal urethral closure pressure, postvoid residual and the maximum urinary flow rate. Conclusions QOL score reflects the patients＂ continent ability, subjective feelings on quality of life. It is correlated with the common urodynamic parameters. QOL score might be used as a new index to estimate the function of orthotopic neobladder.

关 键 词：膀胱切除术 原位肠代膀胱 生活质量评分 尿动力学 

分 类 号：R737.14[医药卫生—肿瘤]