Ross Lone, Abild-Nielsen Annemette G, Thomsen Birthe L, Karlsen Randi V, Boesen Ellen H, Johansen Christoffer
Institute of Cancer Epidemiology, Danish Cancer Society, 49 Strandboulevarden, DK-2100, Copenhagen, Denmark.
Support Care Cancer. 2007 May;15(5):505-13. doi: 10.1007/s00520-006-0177-8. Epub 2006 Nov 14.
As part of a psychosocial intervention study, we wanted to prospectively assess the quality of life of colorectal cancer patients who were given a stoma at the time of their initial operation for cancer or later and those whose initial stoma was removed.
A total of 249 colorectal cancer patients were recruited and responded to a questionnaire 3, 6, 12 and 24 months after the initial operation (26-35% had a stoma during follow-up).
Although most of the differences between stoma and non-stoma patients failed to reach significance, 22 out of 27 variables indicated a poorer quality of life for those with a stoma. Patients who currently had a stoma had significantly higher levels of depression (p = 0.013), poorer social functioning (p = 0.0085) and more problems with body image (p = 0.0001), future perspectives (p = 0.0058), micturition (p = 0.018) and side effects from chemotherapy (p = 0.008), but fewer problems with constipation (p = 0.034) than non-stoma patients. Male patients with a stoma had more sexual problems than males without a stoma (p = 0.015). Among those with a current stoma, quality of life seemed poorer among those whose stoma was made during follow-up compared with those with an initial stoma.
Trends suggested that having a stoma led to poorer scores in most aspects of quality of life and that having a stoma made some time after the initial operation was more distressing than having a stoma made during the primary cancer operation.
作为一项社会心理干预研究的一部分，我们希望前瞻性地评估在初次癌症手术时或之后接受造口术的结直肠癌患者以及初次造口被切除的患者的生活质量。
共招募了249名结直肠癌患者，并在初次手术后3、6、12和24个月对其进行问卷调查（随访期间26 - 35%的患者有造口）。
尽管造口患者和非造口患者之间的大多数差异未达到显著水平，但27个变量中有22个表明造口患者的生活质量较差。目前有造口的患者抑郁水平显著更高（p = 0.013），社会功能较差（p = 0.0085），身体形象问题更多（p = 0.0001），对未来的展望更差（p = 0.0058），排尿问题更多（p = 0.018），化疗副作用更多（p = 0.008），但便秘问题比非造口患者少（p = 0.034）。有造口的男性患者比没有造口的男性有更多性问题（p = 0.015）。在目前有造口的患者中，随访期间造口的患者生活质量似乎比初次就有造口的患者更差。
趋势表明，有造口会导致生活质量的大多数方面得分较低，并且在初次手术后一段时间进行造口比在原发性癌症手术时进行造口更令人痛苦。
