膀胱癌患者输尿管腹壁双造口术后生活质量及影响因素分析  

Quality of life and influencing factors analysis in bladder cancer patients after bilateral ureterostomy with abdominal stoma

作　　者：巫冬梅 黄丽芳[2] 黄敏玉[1] 范元仙[3] 何昌莹 黄美秋[1] Wu Dongmei;Huang Lifang;Huang Minyu;Fan Yuanxian;He Changying;Huang Meiqiu(Department of Urology,Baidong Branch of Affiliated Hospital of Youjiang Medical University for Nationalities,Baise Guangxi 533000,China;First Ward Area of Urology Department,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise Guangxi 533000,China;Second Ward Area of Urology Department,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise Guangxi 533000,China)

机构地区：[1]右江民族医学院附属医院百东院区泌尿外科,广西百色533000 [2]右江民族医学院附属医院泌尿外科一病区,广西百色533000 [3]右江民族医学院附属医院泌尿外科二病区,广西百色533000

出　　处：《保健医学研究与实践》2024年第4期72-77,共6页Health Medicine Research and Practice

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-L20220891)。

摘　　要：目的分析膀胱癌患者输尿管腹壁双造口术后生活质量变化情况及影响因素。方法选取我院2018年1月—2023年1月收治的70例行输尿管腹壁双造口术治疗的膀胱癌患者作为研究对象。使用简明生活质量量表(SF-36)评估其术后7 d、术后1个月的生活质量,并按照术后7 d至术后1个月SF-36评分变化情况,将评分下降≥20%者纳入下降组,评分下降<20%及升高者纳入未下降组。对比2组患者肿瘤分期、淋巴结转移等临床资料,使用多因素Logistic回归分析影响患者生活质量的相关因素。结果患者术后1个月SF-36总分较术后7 d有所升高,差异有统计学意义(P<0.05)。70例患者中,29例(41.43%)患者术后1个月SF-36评分较术后7 d下降≥20%。下降组与未下降组家庭月收入、非造口相关不适、术后并发症、术后康复训练情况及复诊频次比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析示,家庭月收入<3000元、合并非造口相关不适、有术后并发症、复诊频次<2次/月是影响膀胱癌患者输尿管腹壁双造口术后生活质量的独立危险因素,术后康复训练为保护性因素(P<0.05)。结论多数膀胱癌患者输尿管腹壁双造口术后生活质量改善,但也有部分患者出现生活质量下降,与医疗经济负担、躯体不适感、缺乏社会支持等因素有关,积极开展康复训练有助于患者生活质量的改善。Objective To analyze the changes in the quality of life of bladder cancer patients after bilateral ureterostomy with abdominal stoma and its influencing factors.Methods Seventy bladder cancer patients who underwent bilateral ureterostomy with abdominal stoma from January 2018 to January 2023 were selected.The 36-Item Short-Form Health Survey(SF-36)was used to evaluate their quality of life at 7 days and 1 month postoperatively.Patients with a≥20%decrease in SF-36 score from 7 days to 1 month postoperatively were included in the decline group,while others were in the non-decline group.Clinical data such as tumor stage,and lymph node metastasis were compared.Multivariate logistic regression analysis was conducted to identify influencing factors of the quality of life of these patients.Results The SF-36 scores at 1 month postoperatively were significantly higher than at 7 days postoperatively(P<0.05).Of the 70 patients,29(41.43%)experienced a≥20%decrease in SF-36 scores at 1 month postoperatively compared with scores at 7 days.Significant differences were found between the decline and non-decline groups in terms of monthly family income,non-stoma-related discomfort,postoperative complications,postoperative rehabilitation training,and follow-up frequency(P<0.05).Multivariate logistic regression analysis showed that monthly family income<3000 yuan,non-stoma-related discomfort,postoperative complications,and follow-up frequency<2 times per month were independent risk factors for quality of life of bladder cancer patients receiving bilateral ureterostomy with abdominal stoma,while postoperative rehabilitation training was a protective factor(P<0.05).Conclusion While most bladder cancer patients show gradual improvement in quality of life after bilateral ureterostomy with abdominal stoma,some show declined quality of life,which is related to economic burden,physical discomfort,and lack of social support.Active rehabilitation training can help improve their quality of life.

关 键 词：膀胱癌 腹壁双造口术 生活质量 影响因素 

分 类 号：R737.14[医药卫生—肿瘤]