Sharma A, Sharp D M, Walker L G, Monson J R T
Academic Surgical Unit, University of Hull, Castle Hill Hospital, Cottingham, Hull, HU16 5JQ, UK.
Ann Surg Oncol. 2007 Dec;14(12):3435-42. doi: 10.1245/s10434-007-9554-x. Epub 2007 Sep 27.
Measurement of quality of life (QoL) is assuming increasing importance in cancer care. Predictors of early postoperative QoL after colorectal cancer resection are not clear and the aim of this study was to identify these factors.
A consecutive series of eligible patients undergoing elective resection for colorectal cancer were invited to participate. Standardised, reliable and validated psychological questionnaires (HADS, PANAS, MRS, FACT-C, EQ-5D) were administered seven days prior to surgery and then six weeks after discharge.
One hundred and four patients with colorectal cancer were recruited. There were 70 males (67.3%) and the mean age of the group was 67.6 years. Postoperative anxiety and depression were closely related to the preoperative anxiety and depression scores (p < 0.001). Other QoL scores also showed significant correlation with the respective preoperative scores. Anxiety, depression, and FACT functional wellbeing scores were also correlated with the incidence of postoperative morbidity. On multiple regression analysis postoperative morbidity, tumour node metastasis (TNM) stage, presence of stoma and preoperative QoL scores were found to independently predict postoperative QoL scores.
Routine preoperative QoL measurement in cancer patients can identify patients at risk of having a poor QoL postoperatively. Suitable psychological and pharmaceutical intervention can be planned in advance for this group.
生活质量（QoL）的测量在癌症护理中日益重要。结直肠癌切除术后早期生活质量的预测因素尚不清楚，本研究的目的是确定这些因素。
邀请一系列连续接受择期结直肠癌切除术的符合条件的患者参与。在手术前七天和出院后六周分别进行标准化、可靠且经过验证的心理问卷（医院焦虑抑郁量表、积极和消极情感量表、医学应对问卷、癌症患者生活质量量表、欧洲五维度健康量表）调查。
招募了104例结直肠癌患者。其中男性70例（67.3%），该组患者的平均年龄为67.6岁。术后焦虑和抑郁与术前焦虑和抑郁评分密切相关（p<0.001）。其他生活质量评分也与各自的术前评分显示出显著相关性。焦虑、抑郁和癌症患者生活质量量表功能健康评分也与术后并发症的发生率相关。多元回归分析发现，术后并发症、肿瘤淋巴结转移（TNM）分期、造口的存在和术前生活质量评分可独立预测术后生活质量评分。
对癌症患者进行常规术前生活质量测量可以识别术后生活质量较差风险的患者。可以提前为该组患者制定合适的心理和药物干预措施。
