2型糖尿病患者胃转流术后1年生活质量的影响因素分析

摘要

目的：探讨影响2型糖尿病患者胃转流术后生活质量的相关因素，为制定整体护理措施，提高患者的心理健康水平和改善生活质量提供理论依据。方法本研究为横断面调查研究，根据便利抽样法采用2型糖尿病一般情况调查表，糖尿病患者特异性生活质量量表( DSQL)、自评焦虑量表和社会支持量表对2011年5月—2015年5月在上海市第六人民医院内分泌代谢科进行胃转流术130例患者，分别于术前及术后1年随访时进行问卷调查。对调查数据应用SPSS 18.0软件包进行描述性统计、t检验、方差分析和多元逐步回归分析。结果实施胃转流术的2型糖尿病患者术后1年生活质量改善， DSQL总分从(75.98±14.48)降至(52.12±10.35)分，与术前比较差异有统计学意义(P<0.05)；继续使用口服降糖药物治疗的比例下降至5.9％。影响生活质量的因素为病程、年龄、体质量指数、焦虑、药物治疗及社会支持( P<0.05)。结论在术前严格控制手术指征的前提下，加强患者的心理疏导，强调定期随访的重要性，加强社会支持等措施将有助于提高患者术后生活质量。%Objective To investigate the influencing factors of quality of life ( QOL) in patients with type 2 diabetes mellitus ( T2DM ) after gastric bypass, and provide theoretical basis for developing holistic nursing measures and improving the mental health level and the life quality of patients.Methods Four different questionnaires including the general situation questionnaire, diabetes-specific quality of life scale ( DSQL) , self-rating anxiety scale ( SAS) , and social support rating scale ( SSRS) were used to investigate diabetic patients hospitalized in our hospital between May 2011 and May 2015 according to the convenience sampling medthod. The investigation was conducted in the follow-up of 1 year before and 1 year after surgery. Surveying data was analyzed by descriptive statistics, t-test, analysis of variance and multiple stepwise regression analysis through SPSS 18.0 software. Results The QOL of participants significantly improved one year after the surgery. The score of DSQL decreased from ( 75. 98 ± 14. 48 ) to ( 52. 12 ± 10. 35 ) , and there was significant difference compared with data before surgery ( P<0. 05 ) . The proportion of patients who continued to take oral hypoglycemic agents decreased to 5. 9%. Influencing factors that affect the QOL were: the course of disease, age, body mass index (BMI), anxiety, drug treatment and social support (P<0.05).Conclusions In the premise of strict operative indications, the QOL of postoperative patients will be promoted by strengthening the psychological guidance, social support and emphasizing the importance of regular follow-up.