新疆肝移植手术患者生存质量的调研与影响因素探讨

发布时间：2018-05-01 21:22

本文选题：新疆 + 肝移植　；参考：《新疆医科大学》2015年硕士论文

【摘要】：目的：调查和了解新疆肝移植患者术后的生存质量,探索影响该人群生存质量的主要影响因素,为医护人员实施有效的心理干预和术后相关的随访工作提供依据,从而也对提高患者的生存质量提供科学的依据。方法：对新疆某三级甲等医院自2000年首例肝移植至2014年8月所有术后并目前存活且具有独立自主意识能够进行自我评价的患者共计31例进行普查,包括人口学调查、中文版SF-36健康量表问卷调查和访谈三部分内容。结果：肝移植患者在8个维度得分范围为(60.6+18.7)-(93.9士22.1)。原发疾病、手术方式、婚姻状况、文化程度、职业、性别和年龄对生存质量的某些维度有影响：不同年龄间较年轻的患者,拥有相对较好的生存质量水平,主要表现为具有更好的生理职能和活力以及总体健康；不同性别间女性在情感职能和精神健康维度得分低于男性,而在躯体疼痛维度大于男性；不同文化程度的患者在情感职能和精神健康两个维度有差异,但是趋势不明显；不同婚姻状况的患者在生理职能、活力、情感职能、精神健康四个维度有差异,且趋势为已婚患者高于未婚患者高于离异患者,其中精神健康与趋势相反；不同原发疾病患者在社会功能和精神健康维度得分有差异；不同手术方式与职业分别且仅在生理功能和总体健康维度得分有差异。新疆肝移植患者的生存质量与普通人群比较,在生理功能(PF)、活力(VT)、社会功能(SF)和精神健康(MH)四个维度得分P0.05,差异有统计学意义；新疆肝移植患者与美籍华人在生理功能(PF)、躯体疼痛(BP)、活力(VT)、社会功能(SF)和精神健康(MH)维度得分P0.05,差异有统计学意义；新疆肝移植患者与美国人群在生理功能(PF)、躯体疼痛(BP)、总体健康(GH)、活力(VT)和社会功能(SF)维度得分P0.05,差异有统计学意义。本次研究肝移植患者在评价生存质量方面的得分与欧美国家研究相似。新疆肝移植患者术后访谈发现患者身体健康状况自评良好,心理及经济压力大,家属及社会支持自评大部分满意。结论：年龄较年轻、男性、文化程度较低、婚姻状况为已婚、职业为个体、手术方式为活体肝移植的肝移植患者,拥有相对较好的生存质量水平不同且不同原发疾病间患者在社会功能(SF)和精神健康(MH)维度得分有差异；新疆肝移植患者的生存质量评分与普通人群、美籍华人和美国人群接近,与普通人群比较其评分在4个维度分别为生理功能(PF)、活力(VT)、社会功能(SF)和精神健康(MH)维度略高于普通人群,与美籍华人和美国人群比较其评分在生理功能(PF)、躯体疼痛(BP)、总体健康(GH)、活力(VT)和社会功能(SF)五个维度分别有差异,除考虑到人种文化等差异,这可能与患者术后遵医嘱和及时与主治大夫联系等注意医疗保健等有关,这也与后期个案管理人员的定期随访密不可分,同时证明了肝移植手术是对终末期肝病治疗的一种非常有效的治疗方法。
[Abstract]:Objective: to investigate the quality of life (QOL) of patients with liver transplantation in Xinjiang, and to explore the main influencing factors on the quality of life, and to provide evidence for effective psychological intervention and follow-up work. It also provides scientific basis for improving the quality of life of patients. Methods: a total of 31 patients, including demographics, who had survived after liver transplantation from 2000 to August 2014 in a certain Grade 3A Hospital in Xinjiang and were able to conduct self-evaluation with independent consciousness, were surveyed. Chinese version of SF-36 Health scale questionnaire and interview three parts. Results: the scores of liver transplantation patients in 8 dimensions ranged from 60.6 18.7 to 93.9 卤22.1g. Primary diseases, surgical procedures, marital status, education, occupation, sex, and age have an impact on some dimensions of quality of life: younger patients of different ages have a relatively good quality of life. The scores of emotional function and mental health of female were lower than that of male, but the score of somatic pain was higher than that of male. Patients with different education levels have different emotional functions and mental health dimensions, but the trend is not obvious; different marital status of patients in the physiological function, vitality, emotional function, mental health, there are differences in four dimensions, And the trend is that the married patients are higher than the unmarried patients higher than the divorced patients, the mental health is opposite to the trend, the scores of social function and mental health of the patients with different primary diseases are different. The scores of physiological function and overall health dimension were different in different operation ways and occupations. The quality of life of the patients with liver transplantation in Xinjiang was compared with that of the general population. There were significant differences in the scores of four dimensions (P0.05) in the physiological function of PFD, VTN, SFS and MH. The scores of physiological function, body pain, VT, social function and mental health of Xinjiang liver transplantation patients were significantly higher than those of Chinese Americans (P 0.05). There were significant differences in the scores of physiological function PFD, somatic pain, general health, VT, and social function (SFF) between Xinjiang liver transplantation patients and American people (P 0.05). In this study, the score of quality of life for liver transplant patients was similar to that in European and American countries. Interviews with patients with liver transplantation in Xinjiang showed that the patients had good self-assessment of their physical health, high psychological and economic pressure, and most of them were satisfied with the self-assessment of family members and social support. Conclusion: the age is younger, the male is lower, the education level is lower, the marriage status is married, the occupation is the individual, the operation way is the living donor liver transplantation liver transplant patient, The scores of social function and mental health MH were different among patients with different primary diseases, and the scores of quality of life of patients with liver transplantation in Xinjiang were close to those of the general population, Chinese Americans and American people. Compared with the general population, the scores in the four dimensions of physiological function, VT, SFH and MH were slightly higher than those in the general population. Compared with the Chinese Americans and the American population, there were differences in the five dimensions of physiological function, body pain, general health, VTT and social function, except for the differences of human culture, etc. This may have something to do with the patient's compliance with the doctor's instructions after the operation and timely contact with the doctor to pay attention to medical care, which is also closely related to the regular follow-up of the case managers in the later period. At the same time, liver transplantation is proved to be a very effective treatment for end-stage liver disease.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.3

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