胸腹腔镜联合食管癌根治术后患者症状困扰与生活质量的相关性研究

摘要

目的 探讨胸腹腔镜联合食管癌根治术后患者症状困扰与生活质量的关系.方法 采用方便抽样法选取2016年12月～2017年4月新疆某三级甲等肿瘤专科医院收治的胸腹腔镜联合食管癌根治术后患者94例进行问卷调查,分析患者疾病困扰状况和生活质量评分,采用Pearson相关分析法对食管癌根治术后患者的症状困扰与生活质量的相关性进行分析.结果 胸腹腔镜联合食管癌根治术后患者困扰程度最大的是对前景的担忧,其余依次为外表的改变、疲劳、疼痛、失眠、食欲不振等.患者术后生活质量各功能领域中,认知功能维度得分最高,躯体功能状况维度得分最低.在症状领域及单项条目中,认知功能、情绪功能、腹泻得分与Norwegian常模比较,差异无统计学意义(P＞ 0.05);躯体功能、角色功能、社会功能、总体健康状况、便秘、、疼痛得分均低于常模,差异有统计学意义(P＜0.05);气短、食欲下降、疲乏、恶心呕吐、失眠、经济困难均高于常模,差异有统计学意义(P＜0.05).Pearson相关分析显示,症状困扰得分与生活质量总体健康状况及躯体功能、情感功能、社会功能、认知功能和角色功能得分均呈负相关(P＜ 0.001).结论 食管癌根治术后患者的症状困扰普遍存在,且受多重症状困扰,生活质量处于较低水平,护理人员应重视对患者的症状评估和管理,关注护理结局,以提高食管癌术后患者的生活质量.%Objective To investigate the relationship between symptom distress and quality of life in patients with thoracic and laparoscopic radical resection of esophageal carcinoma.Methods From December 2016 to April 2017,94 patients with esophageal cancer treated by thoracic laparoscopy combined with radical resection of esophageal carcinoma were investigated by convenient sampling method,and the status of symptom distress and the quality of life score were analyzed.Pearson correlation analysis was used to analyze the correlation between symptom distress and quality of life after radical resection of esophageal carcinoma.Results The most plagued for patients with thoracic laparoscopy combined with radical esophagectomy was the concern for the prospects,the rest in turn were the appearance changes,fatigue,pain,insomnia,loss of appetite and so on.The score of cognitive functional dimension was the highest and the somatic functional status were the lowest in all functional areas of postoperative quality of life.There were no significant differences in the scores of cognitive function,emotional function,diarrhea when compared with Norwegian norm in symptom domains and single item (P ＞0.05);the scores of physical function,role function,social function,general health status,constipation and pain were lower than the norm,with statistically significant differences (P ＜ 0.05);Shortness of breath,loss of appetite,fatigue,nausea and vomiting,insomnia,economic difficulties were higher than the norm (P ＜ 0.05).Pearson correlation analysis showed that the scores of symptom distress were negatively correlated with the overall health status,physical function,emotional function,social function,cognitive function and role function of quality of life (P ＜ 0.001).Conclusion After radical resection of esophageal cancer,the symptoms of the patients are common and suffer from multiple symptoms,the quality of life is at a low level.Nursing staff should pay attention to the evaluation and management of patients' symptoms,pay attention to the outcome of nursing care,so as to improve the quality of life in patients with esophageal cancer after operation.