| 陈艳玲,黄玉莲,罗 琳,陈梅珠,汪艳清,林冬颜.直肠癌切除术患者永久性与临时性造口术后生活质量变化及其与排便症状的相关性研究[J].,2021,(18):3559-3563 |
| 直肠癌切除术患者永久性与临时性造口术后生活质量变化及其与排便症状的相关性研究 |
| The Changes of Quality of Life after Permanent and Temporary Colostomy in Patients with Rectal Cancer Resection and Their Correlation with Defecation Symptoms |
| 投稿时间：2020-12-21 修订日期：2021-01-17 |
| DOI：10.13241/j.cnki.pmb.2021.18.035 |
| 中文关键词: 直肠癌 永久性造口 临时性造口 生活质量 排便症状 |
| 英文关键词: Rectal cancer Permanent stoma Temporary stoma Quality of Life Defecation symptoms |
| 基金项目:海南省卫生计生行业科研项目（1801032869A2004） |
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| 中文摘要: |
| 摘要 目的：探讨直肠癌切除术患者永久性与临时性造口术后生活质量变化，并分析其生活质量与排便症状的相关性。方法：纳入我院2017年4月～2020年4月收治的直肠癌切除术患者110例，所有纳入者均行造口术。根据造口方式，分成永久性造口组（简称永久组，n=41）、临时性造口组（简称临时组，n=69）。记录两组造口并发症发生率，分别在患者术后1、3、6个月，采用简明生活质量量表（SF-36）评估其生活质量，采用排便症状量表评估患者排便症状的变化。经Pearson线性相关分析患者生活质量评分与排便症状评分的相关性。结果：临时组造口并发症发生率（8.90%）与永久组（12.20%）比较无差异（P＞0.05）。两组术后3、6个月SF-36各维度评分均高于术后1个月，术后6个月各评分高于术后3个月，且临时组术后3个月SF-36各维度评分高于永久组（P＜0.05），但两组术后6个月各评分比较无差异（P＞0.05）。两组术后3、6个月大便症状各评分均低于术后1个月，术后6个月的排便急迫感、排便费力、里急后重评分及总分低于术后3个月，且临时组术后3个月的排便急迫感、排便费力、里急后重评分及总分低于永久组（P＜0.05），但两组术后6个月排便症状各评分比较未见差异（P＞0.05）。Pearson线性相关分析显示，排便症状总分与机体疼痛、躯体功能、躯体角色受限、情感角色受限、心理健康、社会功能、总体健康评分呈负相关（P＜0.05）。结论：直肠癌切除术患者临时性造口能够进一步促进术后3个月生活质量、排便功能的改善，在术后6个月，永久性造口患者的生活质量、排便功能基本达到临时性造口患者的状态，且排便功能与生活质量具有相关性。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the changes of quality of life in patients with rectal cancer after permanent and temporary colostomy, and to analyze the correlation between quality of life and defecation symptoms. Methods: From April 2017 to April 2020, 110 patients with rectal cancer resection in our hospital were enrolled. All the patients underwent stoma. According to the stoma method, they were divided into permanent stoma group (abbreviated as permanent group, n=41) and temporary stoma group (abbreviated as temporary group, n=69). The incidence of ostomy complications was recorded in the two groups. The concise quality of life scale(SF-36) was used to evaluate the quality of life of the patients at 1, 3, and 6 months after operation, and the bowel symptom scale was used to evaluate the changes in defecation symptoms. Pearson linear correlation analysis was used to analyze the correlation between the patient's quality of life score and the defecation symptoms score. Results: The incidence rate of stoma complications in the temporary group (8.90%) was not different from that in the permanent group(12.20%)(P>0.05). The scores of each dimensions of SF-36 in the two groups at 3 and 6 months after operation were higher than that at 1 month after operation, and the scores at 6 months after operation were higher than that at 3 months after operation, and the scores of each dimensions of SF-36 in the temporary group at 3 months after operation were higher than the permanent group(P<0.05), but there was no difference in the scores at 6 months after operation(P>0.05). The scores of stool symptoms in the two groups at 3 and 6 months after operation were lower than that at 1 month after operation. The scores and total scores of urgency of defecation, effort to defecate and tenesmus at 6 months after operation were lower than those of 3 months after operation, the scores and total scores of urgency, effort to defecate and tenesmus in the temporary group at 3 months after operation were lower than those in the permanent group(P<0.05), but there was no difference in the scores of defecation symptoms between the two groups at 6 months after operation (P>0.05). Pearson's linear correlation analysis showed that the total score of defecation symptoms were negatively correlated with body pain, physical function, physical role limitation, emotional role limitation, mental health, social function, and overall health score(P<0.05). Conclusion: Temporary stoma in patients undergoing rectal cancer surgery can further improve the quality of life and defecation function at 3 months after operation. At 6 months after operation, the quality of life and defecation function of patients with permanent stoma basically reach the status of temporary stoma patients, and bowel function is related to quality of life. |
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