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目的探讨手术去势与药物去势治疗对晚期前列腺癌患者生活质量的影响。方法择取大理白族自治州人民医院于2012年11月—2016年1月期间收治的晚期前列腺癌患者50例,遵照随机双盲法将患者分为手术组与药物组,各25例。手术组患者行手术去势治疗,药物组患者行药物去势治疗,观察两组患者生活质量情况。通过生命质量测定量表〔QLQ-C30,包括整体生活质量量表(GH)、经济困难(FD)、腹泻(DI)、便秘(CO)、食欲丧失(AL)、失眠(SD)、呼吸困难(DY)、恶心呕吐(NV)、疼痛(PA)、疲乏(FA)、社会功能(SF)、情绪功能(EF)、认知功能(CF)、角色功能(RF)以及躯体功能(PF)〕、生活质量子量表〔QLQ-PR25,包括性生活质量(SQ)、性愉悦(SE)、性趣(SI)、治疗相关症状(TS)、肠道症状(BS)、尿路症状(US)〕评定患者的生活质量情况。结果治疗前两组患者QLQ-C30评分比较,差异无统计学意义(P>0.05);治疗后手术组患者FA、SD、AL、CO、DI评分高于药物组,PF、RF、EF、CF、SF、GH、NV、PA、DY、FD评分低于药物组,差异有统计学意义(P<0.05)。治疗前两组患者QLQ-PR25评分比较,差异无统计学意义(P>0.05);治疗后手术组患者BS、SI、SE、SQ评分低于药物组,TS评分高于药物组,差异有统计学意义(P<0.05);治疗后两组患者US评分比较,差异无统计学意义(P>0.05)。结论药物去势与手术去势治疗晚期前列腺癌均能改善患者生命健康情况,缓解疼痛程度,改善患者排尿症状,但药物去势较手术去势可更好的保存患者的性功能。
Objective To investigate the effects of surgical castration and drug castration on quality of life in patients with advanced prostate cancer. Methods Fifty patients with advanced prostate cancer admitted to the People’s Hospital of Dali Bai Autonomous Prefecture from November 2012 to January 2016 were selected and randomized into two groups according to a randomized double-blind method. The patients were divided into operation group and drug group, with 25 cases in each group. Patients in the operation group underwent surgical castration. Patients in the drug group underwent castration therapy and the quality of life of the two groups was observed. (QLQ-C30), including quality of life (GH), financial difficulties (FD), diarrhea (DI), constipation (CO), loss of appetite (AL), insomnia (DY), nausea and vomiting (NV), pain (PA), fatigue, social function, emotional function, cognitive function, ], Quality of life subscale [QLQ-PR25, including quality of life (SQ), sexual pleasure (SE), sexual interest (SI), treatment related symptoms (TS), intestinal symptoms (BS), urinary tract symptoms )] To assess the patient’s quality of life. Results There was no significant difference in QLQ-C30 scores between the two groups before treatment (P> 0.05). After treatment, the scores of FA, SD, AL, CO and DI in the operation group were higher than those in the drug group, PF, RF, EF and CF The scores of SF, GH, NV, PA, DY and FD were lower than those of the drug group (P <0.05). There was no significant difference in QLQ-PR25 scores between the two groups before treatment (P> 0.05). The scores of BS, SI, SE and SQ in the operation group were lower than those in the drug group and the TS scores were higher than those in the drug group (P <0.05). There was no significant difference in the US scores between the two groups after treatment (P> 0.05). Conclusion Both castration and surgical castration of advanced prostate cancer can improve the life and health of patients, relieve the pain and improve the symptoms of urination in patients. However, castration is better than castration in preserving the sexual function of patients.