中国普外基础与临床杂志

中国普外基础与临床杂志

结直肠癌术后患者生活质量的研究进展

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目的 总结结直肠癌术后患者生活质量的研究进展。 方法 回顾近年来国内外关于结直肠癌患者术后生活质量的相关研究并作综述分析。 结果 生活质量已成为评价肿瘤患者治疗效果与预后转归的重要标准。目前,国内外对结直肠癌患者生活质量的测评工具主要包括以健康调查简表(SF-36)为代表的普适性量表,以欧洲癌症研究与治疗组织开发的生活质量核心量表(EORTC QLQ-C30)以及欧洲癌症研究与治疗组织开发的大肠癌生活质量专用量表(EORTC QLQ-CR38)为代表的癌症患者适用量表,以及造口患者专用量表如造口患者生活质量问卷(COH-QOL-OQ)、造口患者生活质量量表(Stoma-QOL)、造口生活质量量表(SQOLS)等。患者术后短期生活质量以术后 1 个月时较低,至术后 3 个月时有所恢复。术后 5 年后的长期生活质量亦应引起重视。此外,文献回顾发现,患者术后生活质量受年龄、职业状态、经济、术前体力活动水平、心理及社会因素、人格、手术方式、术前合并症、术后并发症、术后肠造口等因素的影响。 结论 医务人员应在了解术后患者生活质量纵向变化规律及其影响因素的基础上,准确把握有效干预的时间节点,选择恰当的测评工具开展评估和干预,这对于进一步优化临床管理路径,提高结直肠癌术后患者生活质量水平具有重要意义。

Objective To summarize research progress of quality of life in patients after colorectal cancer surgery. Methods The literatures about quality of life of patients with colorectal cancer surgery in recent years are reviewed. Results Quality of life had became an important criterion for evaluating the therapeutic effect and prognosis of cancer. At present, the assessment tools for the quality of life of colorectal cancer patients (CRCs) mainly included the universal scale [such as Short Form Health Survey (SF-36)], the applicable scales for cancer patients [such as European Organization for Research and Treatment of Cancer: quality of life questionaire-C30 (EORTC QLQ-C30) and European Organization for Research and Treatment of Cancer: quality of life questionaire-CR38 (EORTC QLQ-CR38)], and the special scales for stoma patients represented by City of Hope Quality of Life-Ostomy Questionnaire (COH-QOL-OQ), Stoma Quality Of Life (Stoma-QOL), Stoma Quality Of Life Scale (SQOLS), and so on. The short-term quality of life of CRCs was lower at 1 month after operation and recovered at 3 months after operation. Five years after surgery, attention should also be paid to the long-term quality of life. Besides, postoperative quality of life of CRCs was affected by age, occupational status, economy, preoperative physical activity level, psychological and social factor, personality, surgical method, co-morbidity, complication, stoma, and so on. Conclusions Understand the longitudinal changes and influencing factors of patients' quality of life after operation, grasp the time point of effective intervention, and select appropriate assessment tools are necessary for medical staff. It is of great significance to further optimize the clinical management pathway and improve the quality of life of patients with colorectal cancer after operation.

关键词: 结直肠癌; 生活质量; 综述

Key words: colorectal cancer; quality of life; review

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