结肠造口灌洗对直肠癌Miles术后患者生活质量的影响  

The influence of colostomy irrigation on quality of life in rectal cancer patients with permanent colostomy after Miles operation

作　　者：钱惠玉[1] 徐文亚[1] 翁亚娟[1] 

机构地区：[1]常州市第一人民医院胃肠外科,213000

出　　处：《中华护理杂志》2014年第7期786-791,共6页Chinese Journal of Nursing

基　　金：常州市卫生局指导性科研项目(编号:WZ201105)

摘　　要：目的探讨规范化结肠造口灌洗对直肠癌Miles术后患者生活质量的影响。方法将156例直肠癌Miles手术患者随机分为实验组(78例)和对照组(78例),实验组采用早期规范化结肠造口灌洗法护理,对照组采用自然排便传统造口袋护理。两组患者均于干预前、干预后1个月、3个月以及6个月时使用欧洲癌症研究与治疗组织研制的生活质量核心量表(EORTC QLQ-C30)V3.0进行测评,并统计造口护理费用。对完成随访、资料完整的124例患者(实验组63例,对照组61例)的数据进行分析。结果随着随访时间延长,两组患者功能领域和总体健康状况领域评分均呈明显上升趋势,实验组的角色、情绪、认知、社会功能和总体健康状况领域评分上升趋势均比对照组明显,差异有统计学意义(P<0.001)。实验组在各随访时间点的角色、情绪、认知、社会和总体健康状况领域评分均明显优于对照组(P<0.001)。随访6个月时,实验组总的造口护理费用低于对照组。结论规范化结肠造口灌洗能显著提高行直肠癌Miles手术患者的生活质量。Objective To investigate the influence of colostomy irrigation on postoperative quality of life in rectal cancer patients with permanent colostomy after Miles operation.Methods Totally 156 rectal cancer patients with permanent colostomy were randomly divided into two groups,78 cases in each group.Standardized colostomy irrigation was implemented in the experimental group,and naturally regulative defecation care was implemented in the control group,respectively.The patients were investigated with the Chinese version of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30（EORTC QLQ-C30） before intervention and 1,3,6 months after intervention.Moreover,the cost of stoma care was estimated.Results After intervention,the scores of functional subscale and overall health in both groups increased significantly.The scores of role function,emotional function,cognitive function,social function and overall health score in the experimental group were significantly higher than those in the control group after intervention （P＜0.001）.The total cost on stoma care in the experimental group was lower than that in the control group within six months.Conclusion Standardized colostomy irrigation can significantly improve the quality of life of rectal cancer patients after Miles operation.

关 键 词：结肠造口术 灌洗 MILES术 生活质量 

分 类 号：R473.73[医药卫生—护理学]