Quality of life in patients with a permanent stoma after rectal cancer surgery.
Quality of life in patients with a permanent stoma after rectal cancer surgery.
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直肠癌术后永久性造口患者的生活质量。
DOI：
10.1007/s11136-016-1367-6
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发表时间：
2017-01
期刊：
影响因子：
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通讯作者：
Strigård K
中科院分区：
文献类型：
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作者：
Näsvall P;Dahlstrand U;Löwenmark T;Rutegård J;Gunnarsson U;Strigård K
健康相关的生活质量 (HRQoL) 评估对于了解患者的观点和医疗保健决策非常重要。造口患者的 HRQoL 常常受到损害。目的是评估有永久性造口的直肠癌患者与无造口患者的 HRQoL。 711 名接受腹会阴切除术或哈特曼手术的直肠癌患者和接受前切除术的对照组 (n = 275) 符合资格。通过邮寄方式发送了四份生活质量调查问卷。通过学生独立 t 检验进行组间平均值的比较。与瑞典背景人群进行了比较。 336 名有造口的患者和 117 名没有造口的患者做出了答复（453/986；46%）。 31.5% 的人存在造口周围膨出或疝气的情况。造口组中 11.7% 因造口旁疝而接受手术。造口患者的心理健康（p = 0.007）、身体形象（p < 0.001）、身体（p = 0.016）和情绪功能（p = 0.003）较差。造口组的疲劳（p = 0.019）和食欲不振（p = 0.027）也更为突出。无造口组的性功能受损 (p = 0.034)。然而，在造口组中，患有膨出/疝气的患者有更多的性问题（p = 0.004）。疼痛与胀痛/疝气有关 (p < 0.001)，对渗漏的恐惧会降低生活质量 (p < 0.001)。与瑞典背景人群相比，HRQoL 受到损害。接受永久性造口的直肠癌手术患者的总体 HRQoL 低于未造口的患者。在造口组中，造口周围的隆起或疝气进一步损害了 HRQoL。
Health-related quality of life (HRQoL) assessment is important in understanding the patient’s perspective and for decision-making in health care. HRQoL is often impaired in patients with stoma. The aim was to evaluate HRQoL in rectal cancer patients with permanent stoma compared to patients without stoma. 711 patients operated for rectal cancer with abdomino-perineal resection or Hartman’s procedure and a control group (n = 275) operated with anterior resection were eligible. Four QoL questionnaires were sent by mail. Comparisons of mean values between groups were made by Student´s independent t test. Comparison was made to a Swedish background population. 336 patients with a stoma and 117 without stoma replied (453/986; 46 %). A bulging or a hernia around the stoma was present in 31.5 %. Operation due to parastomal hernia had been performed in 11.7 % in the stoma group. Mental health (p = 0.007), body image (p < 0.001), and physical (p = 0.016) and emotional function (p = 0.003) were inferior in patients with stoma. Fatigue (p = 0.019) and loss of appetite (p = 0.027) were also more prominent in the stoma group. Sexual function was impaired in the non-stoma group (p = 0.034). However in the stoma group, patients with a bulge/hernia had more sexual problems (p = 0.004). Pain was associated with bulge/hernia (p < 0.001) and fear for leakage decreased QoL (p < 0.001). HRQoL was impaired compared to the Swedish background population. Overall HRQoL in patients operated for rectal cancer with permanent stoma was inferior compared to patients without stoma. In the stoma group, a bulge or a hernia around the stoma further impaired HRQoL.