结肠造口灌洗对永久性结肠造口患者远期生活质量影响的研究  

Effect of Colostomy Lavage on Long-term Quality of Life in Patients with Permanent Colostomy

作　　者：叶新梅[1] 赵洁[1] 何丹丹[1] 姚秋琼[1] YE Xin-mei;ZHAO Jie;HE Dan-dan;YAO qiu-qiong(colorectal and anal surgery,the Sixth Affiliated Hospital of Sun Yat sen University,Guangdong Guangzhou 510655)

机构地区：[1]中山大学附属第六医院结直肠肛门外科,广东广州510655

出　　处：《实用临床护理学电子杂志》2020年第18期2-4,12,共4页Electronic Journal of Practical Clinical Nursing Science

摘　　要：目的探讨结肠造口灌洗对永久性结肠造口患者远期生活质量的影响。方法将我院于2013年1月至2015年12月在我院行永久性结肠造口的110例连续性病例作为研究对象,将患者随机分为结肠造口灌洗组(n=55)和自然排便组(n=55),采用癌症患者生命质量测定量表(EORTC QLQ-C30)于术后1、6、12和24个月对两组患者进行生活质量的调查,并采用电话或微信随访的方式,在术后24个月对结肠造口灌洗组进行心理弹性量表简化版(CD-RISC10)、希望量表(HHI)、正性负性情绪量表(PANAS)的调查,评估术后24个月结肠造口灌洗组患者的生活质量与心理弹性、希望特质以及整形情绪水平的相关性。结果术后1个月的结肠造口灌洗组的情绪功能评分明显高于自然排便组(P<0.05),术后1、6、12和24个月的结肠造口灌洗组的角色功能和社会功能均明显高于自然排便组(P<0.01);术后24个月结肠造口灌洗组的CD-RISC 10、HHI、PANAS的平均评分分别为(27.8±9.2)分、(22.1±4.1)分和(31.7±8.4)分,其生存质量的角色功能、情绪功能、认知功能、社会功能以及总体生活质量评分与心理弹性、希望特质和正性情绪均为显著正相关(P<0.05)。结论结肠造口灌洗可以有效提高永久性结肠造口患者的生活质量,心理弹性较好、希望特质、正性情绪对其生活质量具有积极影响。Objective To investigate the effect of colostomy lavage on the long-term quality of life in patients with permanent colostomy.Methods 110 consecutive cases of permanent colostomy in our hospital from January 2013 to December 2015 were the subjects.The patients were randomly divided into colostomy-lavage group(n=55)and natural-defecation group(n=55).The quality of life was investigated in two groups at 1,6,12,and 24 months after the operation with the quality of life core questionnaire 30 of European organization for research and treatment of cancer(EORTC QLQ-C30).And follow-up by telephone or Wechat,the colostomy-lavage group was investigated by Connor-Davidson resilience scale 10(CD-RISC10),Herth hope index(HHI)and positive and negative affect scale(PANAS)in the 24 months after operation.At the 24 months after the operation,the correlation between quality of life and mental resilience,hope traits and plastic emotional levels was assessed.Results The emotional function score of the colostomy-lavage group in 1 months after operation was significantly higher than that of the natural-defecation group(P<0.05).The scores of role function and social function of the colostomy-lavage group in 1,6,12 and 24 months after operation were significantly higher than that in the natural-defecation group(P<0.01).The average scores of CD-RISC 10,HHI and PANAS in the colostomy-lavage group at 24 months after operation were respectively(27.8±9.2)points,(22.1±4.1)points and(31.7±8.4)points.And the scores of role function,emotional function,cognitive function,social function and overall quality of life in quality of life were positively correlated with resilience,hope trait and positive mood(P<0.05).Conclusion Colostomy lavage can effectively improve the quality of life of patients with permanent colostomy,and psychological resilience,hope trait and positive emotion have a positive effect on their quality of life.

关 键 词：结肠造口灌洗 永久性结肠造口 生活质量 远期 正相关性 

分 类 号：R473[医药卫生—护理学]