造血干细胞移植术后患者生活质量与影响因素分析  

Analysis of postoperative life quality and influence factors of patients with hematopoietic stem cell transplantation

作　　者：范爱飞[1] 温淑平[1] 戴莉[1] 王钧[1] 李国兴[1] 聂大年[2] 范美婷[2] 

机构地区：[1]北京大学深圳医院,深圳518036 [2]中山大学孙逸仙纪念医院,广州510120

出　　处：《国际输血及血液学杂志》2015年第5期377-382,共6页International Journal of Blood Transfusion and Hematology

基　　金：深圳市科技局立项项目（201203018）

摘　　要：目的调查造血干细胞移植（HSCT）术后患者生活质量，并分析其影响因素，为移植后患者的随访和干预提出指导性意见。方法选取2003年10月至2013年10月于北京大学深圳医院及中山大学孙逸仙纪念医院行HSCT的术后患者各64与36例为研究对象。采用《一般资料调查表》和《世界卫生组织生存质量评估简表））（WHOQOL—BREF），对其进行问卷调查。其中，《一般资料调查表》调查项目包括受试者性别、年龄、婚姻状况、受教育程度、疾病种类、移植物抗宿主病（GVHD）严重程度、移植类型及移植时间等；WHOQOL—BREF涉及HScT术后患者生活质量的生理、心理、环境及社会关系领域4个维度，由26个条目构成，每个条目评分为1～5分，总分为130分。对涉及HSCT术后患者生活质量的调查结果进行单因素和多因素分析。本研究符合北京大学深圳医院和中山大学孙逸仙纪念医院人体试验委员会所制定的伦理学标准，得到该委员会批准，征得受试对象的知情同意，并与之签署临床研究知情同意书。结果本组HSCT术后患者生活质量调查结果：①WHOQOL—BREF总分为61～124分，平均为（96．6±14．1）分；所有条目中，评分最低的为经济状况，仅15％患者认为其经济条件可满足治疗费用需要。②调查结果的单因素分析结果显示，移植类型、GVHD严重程度、移植时间、工作状况、经济状况对HSCT术后患者生活质量的影响，差异均有统计学意义（P〈O．05）。对WHOQOL—BREF4个领域维度进行多元线性回归分析的结果显示，对HSCT术后患者生活质量影响由大到小依次为：生理领域〉心理领域〉环境领域〉社会关系领域。其中，生理领域维度得分与HSCT术后患者生活质量相关性最大（R2=0．815，P=0．000）。结论HSCT术后患者生活质量有待提高，医护人员应加强随访，并采取相应的干预措施，�Objective To investigate the life quality of postoperative patients with hematopoietic stem cell transplantation （HSCT） and analyze its influencing factors, thus putting forward suggestions for follow- up visits and intervention of postoperative patients with HSCT. Methods A total of 64 cases of postoperative patients with HSCT in Beijing University Shenzhen Hospital and 36 cases of postoperative patients with HSCT in Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University were chosen as research objects from October 2003 to October 2013. The General Information Questionnaire and the World Health Organization Quality of Life-Brief （WHOQOL-BREF） were adopted to investigate the patientsr quality of life. The General Information Questionnaire included gender, age, marital status, education level, disease types, the severity of graft versus host disease （GVHD）, the types of transplantation, transplantation time and so on. The WHOQOL-BREF included four dimensions： physiological, psychological, environmental and social relations dimension. It consisted of 26 items and each item was one to five scores, the full mark was 130 scores. The survey results about postoperative life quality of patients with HSCT were analyzed by univariate analysis and multivariate analysis. The study protocol was approved by the Ethical Reviews Board of Investigation in Human Being of Beijing University Shenzhen Hospital and Sun Yat-Sen Memorial Hospital. Informed consent was obtained from all participants. Results （1）The life quality scores of 100 patients were from 61 to 124 scores and the average scores was （96.6±12. 1） scores which was in the medium level. The score of economic status item was lowest, only 15% patients thought that their economic conditions could meet the needs of treatment cost. （2）Univariate analysis results showed that the quality of life after transplantation was closely related to these influencing factors： the transplant type, severity of GVHD, time after transplantation, working conditio

关 键 词：造血干细胞移植 生活质量 影响因素 

分 类 号：R457.7[医药卫生—治疗学]