骨肿瘤患者截肢术后生存质量及相关因素研究  

Study on Quality of Life in Bone Tumor Patients After Amputation Surgery and Its Related Factors

作　　者：白璐 王小芳 秦蒙 王江帆 王世杰 张子茹 Bai Lu;Wang Xiaofang;Qin Meng;Wang Jiangfan;Wang Shijie;Zhang Ziru(Department of Orthopedics,The Second Affiliated Hospital of Air Force Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学第二附属医院骨科,西安710038

出　　处：《成都医学院学报》2024年第6期971-975,共5页Journal of Chengdu Medical College

基　　金：陕西省科学技术厅重点研发计划(No:2023-YBSF-142)。

摘　　要：目的观察骨肿瘤患者截肢术后生存质量状况,并分析影响患者术后生存质量的相关危险因素,为临床早期识别骨肿瘤截肢患者生存质量状况提供参考。方法选取2019年3月至2023年4月某医院收治的骨肿瘤患者125例为研究对象,采用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评估患者截肢术后的生存质量,并收集患者人口学资料(年龄、性别、经济收入等)和临床病例资料(术后化疗、转移灶、复发病灶、截肢部位、幻肢痛、假肢不适、睡眠情况、情绪状态)等相关信息,采用Pearson相关分析法分析患者睡眠情况[采用匹兹堡睡眠质量指数(PSQI)评估]、情绪状态[采用焦虑自评量表(SAS)与抑郁自评量表(SDS)评估]与术后生存质量的相关性,采用多元线性回归模型分析影响患者生存质量的相关因素。结果骨肿瘤患者截肢手术后WHOQOL-BREF评分为(65.37±6.85)分,其中生理维度(15.95±3.45)分、心理维度(13.67±2.16)分、社会关系维度(10.32±2.66)分和环境维度(25.43±4.82)分。患者截肢术后PSQI为(14.36±3.12)分,SAS为(58.46±6.24)分,SDS为(61.42±5.84)分。多元线性回归模型分析显示:女性、半骨盆截肢、大腿截肢、小腿截肢、复发病灶、转移灶及术后化疗、幻肢痛、假肢不适、焦虑、抑郁、睡眠障碍是影响患者术后生存质量的危险因素(P<0.05)。结论骨肿瘤患者截肢术后生存质量处于中等偏低水平,临床可根据筛查出的危险因素制定相应的措施以改善患者术后生存质量。Objective To observe the quality of life of bone tumor patients after amputation surgery and analyze its relevant risk factors,so as to provide reference for early clinical identification of the quality of life in bone tumor patients after amputation surgery.Methods A total of 125 patients with bone tumors admitted to a hospital from March 2019 to April 2023 were included.Their quality of life after amputation surgery was assessed by the World Health Organization Quality of Life Scale Short Form(WHOQOL-BREF).The demographic data(age,gender,income,etc.)and clinical data(postoperative chemotherapy,metastatic lesions,recurrent lesions,amputation site,phantom limb pain,prosthetic discomfort,sleep status,and emotional state)were collected.Pearson correlation analysis was used to analyze the correlation between sleep status[assessed by Pittsburgh Sleep Quality Index(PSQI)],emotional state[assessed by Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)]and postoperative quality of life of patients.And multivariate linear regression model was employed to analyze the related factors affecting the quality of life of patients.Results The WHOQOL-BREF score of bone tumor patients after amputation was(65.37±6.85),with the score of(15.95±3.45)for physiological dimension,(13.67±2.16)for psychological dimension,(10.32±2.66)for social relationship dimension and(25.43±4.82)for environmental dimension.The postoperative scores of PSQI,SAS and SDS were(14.36±3.12),(58.46±6.24)and(61.42±5.84),respectively.Multivariate linear regression model analysis showed that female,semi-pelvic amputation,thigh amputation,calf amputation,recurrent lesions,metastatic lesions and postoperative chemotherapy,phantom limb pain,prosthesis discomfort,anxiety,depression and sleep disorders were risk factors for poor quality of life of patients after surgery(P<0.05).Conclusion The quality of life of bone tumors patients after amputation is at a moderate to low level.clinically corresponding measures can be developed based on the scree

关 键 词：骨肿瘤 截肢术 护理 生存质量 危险因素 

分 类 号：R738.1[医药卫生—肿瘤]