不同手术方式的乳腺癌病人术后2年生活质量对比研究  

Comparative analysis of two-year quality of life in breast cancer patients with different surgical methods

作　　者：陈丽明[1] 向川江[1] 韦征霞 曾柳玲 黄洁[1] 

机构地区：[1]柳州市人民医院

出　　处：《护理研究（上旬版）》2017年第7期2329-2333,共5页Chinese Nursing Researsh

基　　金：广西壮族自治区卫计委自筹经费科研课题;编号:Z2012566

摘　　要：[目的]探讨乳腺癌不同手术类型病人生活质量状况,为病人术后护理干预提供依据。[方法]选取乳腺癌手术病人404例,其中保乳术74例、改良根治术283例、乳房再造术47例。采用欧洲癌症研究和治疗组织开发的生命质量测定核心量表(EORTC QLQ-C30)、EORTC QLQ-BR23、罗森伯格自尊量表(RESE)、贝克抑郁自评量表(BDI)、体像量表(BIS)及癌症康复评估系统(CARES)对保乳术、改良根治术和乳房再造术病人术后2年的生活质量进行综合评估。[结果]3类手术病人EORTC QLQ-C30中总体健康、功能领域以及EORTC QLQ-BR23功能领域中的性功能得分较高,但在症状领域得分均较低;EORTC QLQ-C30中的情绪功能(F=73.46,P<0.001)、恶心呕吐(F=14.12,P<0.001)以及在EORTC QLQ-BR23中的体像(F=301.21,P<0.001)、性趣(F=21.34,P<0.001)、乳腺症状(F=2.58,P<0.001)、上肢症状(F=11.23,P<0.001)、对脱发的担忧(F=2.17,P=0.03)得分均存在差异;不同手术类型病人RSES(F=211.45,P<0.001)、BIS(F=362.10,P<0.001)以及CARES(F=31.24,P<0.001)量表得分均存在统计学差异(P<0.001)。[结论]与改良根治术病人相比,保乳术和乳房再造术显著改善病人自尊、体像方面的生活质量,加强术后症状干预是提高3类乳腺癌手术病人生活质量的重点方向。Objective：To probe into the quality of life of patients with different types of surgery,and to provide the basis for postoperative care intervention.Methods：A total of 404 patients undergoing breast cancer surgery were selected,including 74 cases of breast conserving surgery,283 cases of modified radical resection and 47 cases of breast reconstruction.A series of scales were conducted to evaluate the 2-year quality of life among breast cancer patients undergoing the 3 different surgeries.The scales were including： The European Organization for Research and Treatment of Cancer QLQ-C30 （EORTC QLQ-C30）,The EORTC breast cancer-specific quality of life questionnaire （EORTC QLQ-BR23）,the Rosenberg Self-Esteem Scale（RSES）,Beck Depression Inventory （BDI）,Body Image Scale （BIS）,and Cancer Rehabilitation Evaluation System （CARES）.Results：The total health score and function score in EORTC QLQ-C30 and the sexual scores in function of EORTC QLQ-BR23 were higher,while the symptom scores were lower.The scores among three groups in emotion function （F=73.46,P〈0.001） and malignant vomiting （F=14.12,P〈0.001） in EORTC QLQ-C30 were statistically different.The scores among three groups in body image （F=301.21,P〈0.001）,sexual interest （F=21.34,P〈0.001）,breast symptoms （F=2.17,P=0.03）,upper limb symptoms （F=11.23,P〈0.001）,and worry on hair loss （F=2.58,P〈0.001） in EORTC QLQ-BR23 were statistically different.The scores among three groups in RSES （F=211.45,P〈0.001）,BIS （F=362.10,P〈0.001） and CARES （F=31.24,P〈0.001） were statistically different （P〈0.05）.Conclusions：Compared with modified radical mastectomy,breast-conserving surgery and breast reconstruction significantly improved the quality of life on patients＇ self-esteem and body image.Enhanced postoperative symptom intervention was the key point to improve the quality of life of patients with breast cancer.

关 键 词：乳腺癌 生活质量 综合评估 保乳术 改良根治术 乳房再造术 自尊 体像 抑郁 

分 类 号：R473.73[医药卫生—护理学]