造血重建对异基因造血干细胞移植患者早期生活质量的影响

摘要

目的 探讨造血重建对异基因造血干细胞移植(HSCT)患者早期生活质量的影响,为针对性干预提供参考.方法 将122例患者以出净化病房时血小板是否重建分为造血重建组(88例)和造血延迟组(34例),采用癌症治疗功能评价系统-骨髓移植生命质量测评量表(FACT-BMT)测评患者在入净化病房前、移植后1、3、6个月生活质量.结果 122例患者不同时间点生活质量得分差异有统计学意义,其中移植后1个月得分最低,6个月时得到显著改善(P＜0.05,P＜0.01);造血重建组前3个时间点生活质量得分显著高于造血延迟组(均P＜0.05).多元回归分析结果显示早期造血重建与否是HSCT患者生活质量的主要影响因素,其次为移植物抗缩主病及性别(均P＜0.05).结论 早期造血重建可作为HSCT患者术后生活质量的预测因素,护理人员应特别注重对造血延迟患者的针对性护理,以助HSCT患者在术后早期获得较好的生活质量.%Objective To investigate the effect of hematopoietic reconstruction on early quality of life of patients receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT),and to provide evidence for targeted interventions.Methods A total of 122 patients after allo-HSCT were divided into a reconstruction group (n=88) and a delayed reconstruction group (n=34) accor-ding to whether platelet reconstruction was built when patients were transferred out of the purification ward.The Functional Assessment of Cancer Therapy-Bone Marrow Transplantation scale (FACT-BMT) was used to evaluate patients' quality of life before transfer to purification ward and 1,3,and 6 months post transplantation.Results Quality of life of the 122 patients had statistical difference at different time points,showing significant decrease at 1 month post transplantation and significant increase at 6 months post transplantation (P＜0.05,P＜0.01).Quality of life at the former 3 time points in the reconstruction group was significantly higher than the delayed reconstruction group (P＜0.05 for all).Multivariate regression analysis showed that early hematopoietic recon struction was the main factor influencing quality of life in patients receiving allo-HSCT,followed by development of graft versushost disease and age (P＜0.05 for all).Conclusion Early hematopoietic reconstruction was a significant predictor of quality of life after allo-HSCT,and attention should be paid to those who had delayed platelet reconstruction,thus to provide targeted intervention for improving their quality of life.