宫颈癌患者腹腔镜术后生存质量调查

发布时间：2018-03-28 21:14

  本文选题：宫颈癌　切入点：根治性子宫切除术　出处：《山东大学》2014年硕士论文

【摘要】：研究背景 宫颈癌是妇科最常见的女性生殖道恶性肿瘤,该病早期常无明显症状和体征,后期可出现阴道流血等症状,病因也尚未完全明了,发病年龄分布广泛,有淋巴转移者预后差。近几十年宫颈细胞学筛查的普遍应用,使宫颈癌和癌前病变得以早期发现和治疗,宫颈癌的发病率和死亡率已有明显下降。腹腔镜手术是一门新发展起来的微创手术方法,具有手术创伤小,术后恢复快,术后疼痛轻,住院时间短,切口瘢痕小等优点,已越来越多地应用在子宫切除手术方面。生存质量作为新兴的对患者生活方面和人生充实感等各个方面总体地、客观地对患者的评价,作为患者治疗后生理和心理方面的综合评价标准,已经受到越来越多的关注。为综合评价宫颈癌患者腹腔镜术后的生存质量,及各种不同因素下患者的生存质量的差别,特作此调查研究。 研究目的 评估宫颈癌患者腹腔镜手术后的生存质量 研究方法 采用流行病学横断面研究的方法,对2010年1月至2013年12月在山东大学第二附属医院妇产科完成治疗的FIGO Ⅰ-Ⅱ期宫颈癌患者进行问卷调查。选用欧洲癌症研究与治疗组织(European Organization for Research and Treatment of Cancer, EORTC)的生存质量核心量表中文版Quality of Life Core Questionaire, QLQ-C30(V3.0)和生存质量测量表之宫颈癌模块中文版(Cervix Cancer Module, EORTC QLQ-CX24)作为调查问卷。通过电话和邮件随访的方式取得生存质量问卷结果。并按照EORTC提供的计算方法与评分标准,对结果进行分析描述。同时,按照随访时间、FIGO分期及年龄3个因素对生存质量调查结果进行分组,使用非参数秩和检验进行统计学分析各组间结果的显著性差异。 结果 在平均随访时间为21.3个月,范围为6.7-44.6个月中,整体健康的生活质量评分较高,表示治疗后患者具有良好的总体生存质量。睡眠障碍、疲劳与食欲不振,更年期症状及周围神经症状评分稍高,表示略有不适,最严重的症状是性功能影响,其余条目评分均较低,表示其余症状均不明显。生存质量调查的结果与随访时间、FIGO分期及年龄3个因素的关系分析,结果显示绝大部分条目无显著性差异,仅在角色功能、认知功能、睡眠障碍、身体形象、总体健康和性忧虑方面,年龄与生存质量结果存在影响关系,其中只有性忧虑方面影响较大,其他项目影响较为轻微。 结论 宫颈癌患者腹腔镜术后整体生存质量良好,仅在睡眠障碍、疲劳与食欲不振及更年期症状方面略有不适,突出表现为性功能影响严重。同时,年龄与生存质量结果在角色功能、认知功能、总体健康和性忧虑方面存在影响关系。
[Abstract]:Research background. Cervical cancer is the most common malignant tumor of female genital tract in gynecology. There are no obvious symptoms and signs in the early stage of the disease, vaginal bleeding can occur in the later stage, the etiology is not fully understood, and the age distribution of the disease is widespread. The prognosis of patients with lymphatic metastasis is poor. In recent decades, the universal application of cervical cytological screening has enabled the early detection and treatment of cervical cancer and precancerous lesions. The incidence and mortality of cervical cancer have decreased significantly. Laparoscopic surgery is a newly developed minimally invasive surgical method with the advantages of small trauma, quick postoperative recovery, light postoperative pain, short hospital stay, small incision scar, and so on. The quality of life, as a newly emerging aspect of the patient's life and a sense of fulfillment in life, has been used more and more in hysterectomy. As a whole, the quality of life objectively evaluates the patient. As a comprehensive evaluation standard of physiology and psychology after treatment, more and more attention has been paid to the comprehensive evaluation of the quality of life of patients with cervical cancer after laparoscopic surgery, and the difference of quality of life among patients with different factors. This investigation is hereby carried out. Research purpose. Evaluation of quality of life in patients with cervical cancer after laparoscopic surgery. Research method. Using the method of epidemiological cross-sectional study, From January 2010 to December 2013, a questionnaire survey was conducted on FIGO stage 鈪，

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