膀胱全切原位尿流改道术患者生命质量下降的术前危险因素  

Analysis of Preoperative Risk Factors for the Decline of Life Quality in Patients with Cystectomy and Orthotopic Neobladder

作　　者：李丹娜[1] 杨明莹[1] 王俊[1] 王留芳[1] 吴光柳 王会笑 陈奖国 姚呈 黄应龙[1] LI Dan-na;YANG IVling-ying;WANG Jun;WANG Liu-fang;WU Guang-liu;WANG Hui-xiao;CHENG Jiang-guo;YAO Cheng;HUANG Ying-long(Dept,of Urology,The 2nd Affiliated Hospital of Kunming Mledical University,Kunming Yunnan 650101,China)

机构地区：[1]昆明医科大学第二附属医院泌尿外科,云南昆明650101

出　　处：《昆明医科大学学报》2018年第9期27-32,共6页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81460384);云南省教育厅科学研究基金重点项目(2016Z091)

摘　　要：目的探讨影响膀胱全切原位尿流改道术患者生命质量下降的关键术前因素,为尽早开展有效干预,预防术后生命质量下降提供依据.方法分析患者人口学资料、术前生理指标和基础生命质量,采用多因素回归分析法,探寻影响术后3个月生命质量的关键因素.结果体质指数异常(BMI≤18.5或BMI≥23.9)和术前合并症评分CCI≥3分是术后3个月生命质量下降的独立影响因素(OR=1.09,95%CI:1.03~1.17,P=0.011;OR=1.62,95%CI:0.48~0.92,P=0.017).在不考虑其它情况的条件下,是否合并糖尿病、COPD和肾病患者生命质量下降发生率并无明显区别.结论关注患者术前基础情况,在整合可用资源的基础上,开展精准有效的、多学科领域协调合作的、贯穿治疗康复全过程的个性化护理管理方案对预防生命质量下降、促进整体康复具有重要意义.Object To analyze the preoperative risk factors for the decline of life quality in patients with cystectomy and orthotopic neobladder so as to provide the guide and evidence of precise nursing intervention.Methods The demographic data, preoperative physiological indexes and basic quality of life were analyzed,and multiple factor regression analysis was used to explore the key factors affecting the quality of life after 3 months of operation.Results On the multivariate analysis adjusted for the influence of competing variables,CCI≥3（OR = 1.62,95%CI： 0.48-0.92,P = 0.017） and abnormal BMI（OR = 1.09,95%CI： 1.03-1.17,P =0.011） were significantly associated with the decrease of quality of life. Conclusion The individualized nursing management program in the multidisciplinary field which runs through the whole process of treatment and rehabilitation is of great significance in preventing the decline of life quality and promoting the overall rehabilitation.

关 键 词：膀胱癌 原位尿流改道术 生命质量 

分 类 号：R737.14[医药卫生—肿瘤]