肝癌患者睡眠障碍与术后生活质量相关性的纵向研究  

Correlation between sleep disorder and postoperative quality of life in patients with liver cancer:a longitudinal study

作　　者：李繁荣 赵新华[1] 唐娟[1] 庞春华[1] 杨莉洁 韦双双 游雪梅[3,4] Li Fanrong;Zhao Xinhua;Tang Juan;Pang Chunhua;Yang Lijie;Wei Shuangshuang;You Xuemei(Department of Hepatobiliary Surgery,Guangxi Medical University Cancer Hospital,Nanning,530021;Department of Head and Neck Surgery,Guangxi Medical University Cancer Hospital,Nanning,530021;Department of Nursing,Guangxi Medical University Cancer Hospital,Nanning,530021;Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumour,Nanning,530021,China)

机构地区：[1]广西医科大学附属肿瘤医院肝胆外科,广西南宁530021 [2]广西医科大学附属肿瘤医院头颈外科,广西南宁530021 [3]广西医科大学附属肿瘤医院护理部,广西南宁530021 [4]广西区域性高发肿瘤早期防治研究重点实验室,广西南宁530021

出　　处：《现代临床护理》2024年第1期14-20,共7页Modern Clinical Nursing

基　　金：国家自然科学基金,项目编号为81960308。

摘　　要：目的 调查肝癌患者从入院到术后6个月的睡眠障碍及生活质量变化,并探讨入院时睡眠障碍与术后6个月生活质量的相关性。方法 选取首次诊断为原发性肝细胞癌并行手术治疗的患者214例作为研究对象,采用一般资料调查问卷、匹兹堡睡眠障碍指数(Pittsburgh sleep quality index,PSQI)及肝胆肿瘤治疗功能评定量表(functional assessment of cancer therapy-hepatobiliary,FACT-Hep),分别在患者入院时、术后1个月、3个月和6个月进行调查;采用多重线性回归及分层回归分析患者术后6个月睡眠障碍对生活质量的影响。结果 入院时214例完成研究,术后1个月209例患者完成研究,术后3个月208例患者完成研究,术后6个月205例患者完成研究。肝癌患者睡眠障碍及生活质量得分随时间变化,差异具有统计学意义(均P<0.001),患者整体睡眠障碍水平呈先升后降的特点,生活质量呈由高到低而后逐渐上升的特点;多重线性回归分析结果显示,患者入院时睡眠障碍是术后6个月生活质量总分降低的因素,分层回归分析结果显示,在BCLC A期患者中,入院时睡眠障碍是术后6个月生活质量的影响因素。结论 从入院到术后6个月肝癌患者的睡眠障碍和生活质量呈动态变化,且入院时发生睡眠障碍的患者术后生活质量较差。医护人员应重视患者术前睡眠管理,对患者睡眠障碍的有无及生活质量进行动态评估,并制定延续性护理干预措施,提高患者术后生活质量。Objective To investigate the sleep disorders and its effects on the changes in quality of life in patients with liver cancer from the hospital admission to 6 months after surgery and to analyse the correlation between the sleep disorder and quality of life.Methods A total of 214 patients who underwent surgery for liver cancer for the first time were included in the study.Demographic questionnaire,Pittsburgh sleep quality index(PSQI),and functional assessment of cancer therapy-hepatobiliary(FACT-Hep)were used for the investigation at admission and at 1,3 and 6 months after surgery.Multiple linear regression was employed to analyse the correlation between the sleep disorders at the admission and its effect on quality of life up to 6 months after surgery.Results Toally 214 patients finished the study at admission and 209 finished the study 1 month after surgery,and 208 finished the stuoly 3 months after surgery,and 205 patients finished the study 6 months after surgery.The scores of both of PSQI at admission and the quality of life at 6 months after surgery varied across the tested time points with a statistically significant difference(both P<0.001).The overall level of sleep disorder in the patients showed a characteristic pattern with initially increasing and then decreasing,and the quality of life presented a characteristic tendency of starting from high to low and then gradually increasing.It showed that the sleep disorder at admission was attributive to the poorer quality of life at 6 months after surgery.The hierarchical regression analysis showed that among the patients at BCLC Stage A,sleep disorder at admission was the influencing factor of the quality of life at 6 months after surgery.Conclusions The sleep disorder and quality of life in the patients who had surgical operations for hepatocellular carcinoma both changed dynamically from admission to the 6 months after surgery.The quality of life was poor in the patients with sleep disorder at admission.Therefore,medical staff should enhance the sleep manag

关 键 词：肝癌 睡眠障碍 生活质量 纵向研究 

分 类 号：R473.73[医药卫生—护理学]