Karadağ Ayişe, Menteş B Bülent, Uner Aytuğ, Irkörücü Oktay, Ayaz Sultan, Ozkan Seçil
Stomatherapy Unit, Department of Surgery, Gazi University Medical School, Ankara, Turkey.
Int J Colorectal Dis. 2003 May;18(3):234-8. doi: 10.1007/s00384-002-0462-z. Epub 2002 Dec 14.
The impact of a stoma on a patient's life is little discussed and is often underestimated, as well as the contribution of stomatherapy to health-related quality of life (QOL). This present study examined the problems faced by patients with ileostomies or colostomies and the possible contribution of stomatherapy to QOL.
Forty-three selected and well-documented stoma patients who had properly constructed, well functioning end colostomies or ileostomies were analyzed. Further analyses were carried out for the subgroups of patients with irrigating colostomies ( n=16), nonirrigating colostomies ( n=15), and ileostomies ( n=12). The digestive disease QOL questionnaire 15 (DDQ-15) was used to analyze QOL before and 3 months after stomatherapy. A second questionnaire consisting of 11 questions with yes/no answers was also used before and 3 months after stomatherapy to define more specifically the stoma-related problems of each patient as well as the frequency of each issue in a patient group at a given time.
Cumulatively the mean QOL score was significantly higher after stomatherapy than before. Before stomatherapy the irrigating colostomy patients had the highest QOL score and the ileostomy group the lowest. QOL scores 3 months after stomatherapy were significantly higher in all groups than before. Again, the irrigating colostomy patients had a significantly higher score than the nonirrigating colostomy and ileostomy patients. Cumulatively all of the items improved significantly after stomatherapy, such as getting dressed, bathing, and participating in sports.
These findings confirm that colostomy or ileostomy has a profoundly negative impact on QOL. Specialized counseling of these patients by a dedicated team improves QOL significantly.
造口对患者生活的影响鲜少被讨论，且常常被低估，造口治疗对健康相关生活质量（QOL）的贡献亦是如此。本研究调查了回肠造口术或结肠造口术患者所面临的问题以及造口治疗对生活质量可能产生的影响。
对43例经过挑选且资料完备的造口患者进行分析，这些患者的末端结肠造口术或回肠造口术构建良好且功能正常。对结肠灌洗造口术患者亚组（n = 16）、非结肠灌洗造口术患者亚组（n = 15）和回肠造口术患者亚组（n = 12）进行了进一步分析。采用消化系统疾病生活质量问卷15（DDQ - 15）分析造口治疗前及治疗3个月后的生活质量。还在造口治疗前及治疗3个月后使用了一份由11个是非题组成的问卷，以更具体地确定每位患者与造口相关的问题以及特定时间患者群体中每个问题的出现频率。
总体而言，造口治疗后的平均生活质量得分显著高于治疗前。造口治疗前，结肠灌洗造口术患者的生活质量得分最高，回肠造口术组得分最低。造口治疗3个月后的生活质量得分在所有组中均显著高于治疗前。同样，结肠灌洗造口术患者的得分显著高于非结肠灌洗造口术和回肠造口术患者。总体而言，造口治疗后所有项目均有显著改善，如穿衣、洗澡和参加体育活动等。
这些发现证实结肠造口术或回肠造口术对生活质量有深远的负面影响。由专业团队对这些患者进行专门的咨询能显著提高生活质量。
