直肠癌Mils术后、LAR术后照顾者负担的横纵向变化及对比研究  

Comparative study on transverse and longitudinal changes of caregiver burden in patients with rectal cancer and postoperative LAR

作　　者：黄文领 袁梅 杨璐玭 HUANG Wen-ling;YUAN Mei;YANG Lu-pin(The Affiliated Hospital of Southwest Medical University,646000)

机构地区：[1]西南医科大学附属医院介入医学部

出　　处：《现代消化及介入诊疗》2019年第7期727-732,共6页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：四川省卫生和计划生育委员会科研项目(18ZD014)

摘　　要：目的 调查两种直肠癌根治术后照顾者主观负担的纵向变化,探讨可能的影响因素。方法 收集170例直肠癌患者及其主要照顾者为研究对象。根据手术方式不同,将患者分为LAR组及Mils组。在出院时及出院后3个月,对患者及其主要照顾者进行相关评估。统计分析可能影响照顾者主观负担的危险因素。结果 出院时,两组患者QLQ各维度得分均处于较低水平,且Mils组的各项指标较LAR组均较差。出院3个月后,两组患者QLQ各维度得分均有不同程度提高,Mils组患者恢复更为明显,社会功能得分高于LAR组,仅有腹泻得分小于LAR组,差异具有统计学意义(P<0.05)。出院时,两组照顾者均表现出一定的照顾负担,与LAR组相比,Mils组照顾者的ZBI总分、个人负担、负担程度明显更高(P<0.05);随着康复时间的延长,术后3个月时,两组照顾者的负担水平趋于平衡,均呈下降趋势,各指标差异均无统计学意义(P>0.05)。出院时,Mils组照顾者焦虑评分≥9、抑郁评分≥9的患者比例明显高于LAR组;术后3个月,两组照顾者负面情绪明显平复,差异无统计学意义(P>0.05)。社会功能、总体健康是影响影响LAR组照顾者负担的独立性危险因素(P<0.05);工作状态、照顾者亲属关系、总体健康是影响影响Mils组照顾者负担的独立性危险因素(P<0.05)。结论 直肠癌术后,患者的主要照顾者存在明显的主观负担及焦虑抑郁情绪。在术后3个月内,行Mils术患者的照顾者负担相对较高,在3个月后两种术式趋于平衡。改善患者社会功能、提高总体健康是缓解照顾者负担的最重要措施。Objective To investigate the longitudinal changes in the subjective burden of caregivers after radical resection of two rectal cancers,and to explore the most important measures for possible influencing factors. Methods A total of 170 patients with rectal cancer and their primary caregivers were enrolled. Patients were divided into LAR group and Mils group according to different surgical methods. Patients and their primary caregivers were assessed at the time of discharge and three months after discharge. Statistical analysis may affect the risk factors for the subjective burden of caregivers. Results At the time of discharge,the scores of QLQ in each group were at a lower level,and the indicators in theils group were worse than those in the LAR group. After 3 months of discharge,the scores of QLQ in each group increased in different degrees. The recovery of Mils group was more obvious,the social function score was higher than that of LAR group,and only the diarrhea score was less than LAR group,the difference was statistically significant (P <0. 05). At the time of discharge,both groups of caregivers showed a certain burden of care. Compared with the LAR group,the ZBI total score,personal burden and burden of the care group of theils group were significantly higher (P < 0. 05);The time was prolonged.At the 3 months postoperatively,the burden levels of the two groups of caregivers tended to be balanced,showing a downward trend.There was no significant difference in the indexes (P > 0. 05). At the time of discharge,the proportion of patients with anxiety score ≥9 and depression score ≥9 in the Mils group was significantly higher than that in the LAR group;the negative emotions of the caregivers in the two groups were significantly calmed after 3 months,and the difference was not statistically significant (P > 0. 05). Social function and overall health were independent risk factors affecting the burden of caregivers in the LAR group (P < 0. 05);work status,caregiver kinship,and overall health were independent r

关 键 词：直肠癌 腹会阴联合直肠癌根治术 直肠低位前切除术 

分 类 号：R574[医药卫生—消化系统] R735.3+7[医药卫生—内科学]