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目的评测局限性肾癌患者腹腔镜手术前后生活质量(Qo L),并探讨其变化趋势。方法使用健康调查简表(SF-36)中文版对49例接受腹腔镜手术的局限性肾癌患者进行Qo L评测,所有纳入对象于术前1 d、术后3个月和术后6个月分别填写调查问卷并评分。将Qo L 8个维度术前得分与中国健康常模比较,将术后3个月和6个月得分分别与术前基线水平进行比较。结果本组患者生理职能(RP)、一般健康状况(GH)、精力(VT)、社会功能(SF)、情感职能(RE)、精神健康(MH)等6个维度术前得分低于中国健康常模(P<0.05),而生理机能(PF)、躯体疼痛(BP)2个维度与中国健康常模无明显差异。PF和BP术后3个月较术前下降明显(P<0.05),术后6个月恢复至术前水平;RP、GH、SF和RE术后3个月与术前比较差异无统计学意义,术后6个月高于术前水平(P<0.05);VT术后3个月和6个月与术前比较均差异无统计学意义;MH术后3个月和6个月均较术前明显改善(P<0.05)。结论局限性肾癌患者腹腔镜手术前及手术后早期Qo L下降明显,而术后中晚期逐步恢复或接近正常水平,对于此类患者可及早给与心理干预、行为指导甚至药物治疗,改善患者Qo L。
Objective To evaluate the quality of life (Qo L) before and after laparoscopic surgery in patients with locally advanced renal cell carcinoma and to explore its changing trend. Methods The Chinese version of Health Survey Profile (SF-36) was used to evaluate the QoL in 49 patients with localized renal cell carcinoma undergoing laparoscopic surgery. All patients were enrolled in the study on the first day before operation, 3 months after operation and 6 after operation Month Fill in the questionnaire and score. The preoperative scores of 8 dimensions of Qo L were compared with those of Chinese healthy subjects, and the scores of 3 months and 6 months postoperatively were compared with preoperative baseline levels respectively. Results The preoperative scores of 6 dimensions including physical function (RP), general health (GH), energy (VT), social function (SF), emotional function (RE) and mental health (MH) (P <0.05). However, there was no significant difference between the two dimensions of physiological function (PF) and somatic pain (BP) in Chinese healthy norm. PF and BP decreased significantly 3 months after operation compared with that before operation (P <0.05), and returned to preoperative level 6 months after operation. There was no significant difference between preoperative and postoperative 3 months after RP, GH, SF and RE (P <0.05). There was no significant difference between preoperative and postoperative 3 months and 6 months after VT and 3 months and 6 months postoperatively Compared with preoperative significantly improved (P <0.05). Conclusion In patients with localized renal cell carcinoma, the QoL decreased significantly before and after laparoscopic surgery, and gradually recovered to or near normal levels in the late stage of renal cell carcinoma. Psychological interventions, behavioral counseling and even medication were given to patients with advanced renal cell carcinoma to improve the patients’ Qo L.