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目的研究手术去势和药物去势即雄激素阻断治疗对前列腺癌患者心理及生活质量的影响。方法采用症状自评量表(SCL-90)、癌症患者生命质量测定量表(QLQ-C30)及前列腺癌患者生活质量子量表(QLQ-PR25)对102例接受手术去势治疗和86例接受雄激素阻断治疗的前列腺癌患者,分别在治疗前、治疗后6个月及治疗后12个月的心理及生活质量状况进行评价。结果 SCL-90显示两种治疗方法组在治疗6月后和治疗12月后躯体化、强迫、人际关系、焦虑及精神病性方面均有改善(t分别=2.87、3.91、3.49、4.17、1.99、3.01、3.95、3.74、4.28、4.58;2.09、2.21、2.17、1.99、3.96、1.99、2.13、2.08、1.99、3.73,P均<0.05)。两种方法治疗6月后和治疗12月后都能缓解疼痛和改善排尿(t分别=3.76、4.51,3.51、4.58;2.41、4.37,2.53、4.63,P均<0.05),尤其对治疗6月后的性功能影响较明显(t分别=3.57、3.37,P均<0.05)。药物去势治疗对性功能有不同程度的改善,而手术治疗却造成永久性性功能丧失。结论两种治疗方案都带来不同程度的心理问题,使前列腺癌患者的生活质量下降,但药物去势对部分生活质量的影响是可逆的。
Objective To study the effects of surgical castration and drug-castration and androgen blockade therapy on the psychology and quality of life in patients with prostate cancer. Methods Totally 102 patients undergoing surgical castration and 86 patients undergoing ovariectomy were assessed with the Self-rating Symptom Scale (SCL-90), the Quality of Life Scale of Cancer Patients (QLQ-C30) and the Quality of Life Scale of Prostate Cancer Patients (QLQ-PR25) The prostate cancer patients who underwent androgen blockade were evaluated before treatment, 6 months after treatment and 12 months after treatment, respectively. Results SCL-90 showed improvement in somatization, coercion, interpersonal, anxiety and psychotic status after 6 months of treatment and after 12 months of treatment in both treatment groups (t = 2.87, 3.91, 3.49, 4.17, 1.99, 3.01, 3.95, 3.74, 4.28, 4.58; 2.09, 2.21, 2.17, 1.99, 3.96, 1.99, 2.13, 2.08, 1.99, 3.73, P <0.05). Both treatment of 6 months and 12 months after treatment can relieve pain and improve urination (t = 3.76,4.51,3.51,4.58; 2.41,4.37,2.53,4.63, P <0.05), especially for the treatment of June After sexual function more obvious impact (t = 3.57,3.37, P <0.05). Drug castration treatment of varying degrees of sexual function to improve, but surgery resulted in permanent loss of sexual function. Conclusions Both treatment regimens bring different degrees of psychological problems, which lead to the decline of quality of life in patients with prostate cancer. However, the effects of drug castration on part of the quality of life are reversible.