本文選題：宮頸癌　切入點(diǎn)：根治性子宮切除術(shù)　出處：《山東大學(xué)》2014年碩士論文

【摘要】：研究背景 宮頸癌是婦科最常見的女性生殖道惡性腫瘤,該病早期常無明顯癥狀和體征,后期可出現(xiàn)陰道流血等癥狀,病因也尚未完全明了,發(fā)病年齡分布廣泛,有淋巴轉(zhuǎn)移者預(yù)后差。近幾十年宮頸細(xì)胞學(xué)篩查的普遍應(yīng)用,使宮頸癌和癌前病變得以早期發(fā)現(xiàn)和治療,宮頸癌的發(fā)病率和死亡率已有明顯下降。腹腔鏡手術(shù)是一門新發(fā)展起來的微創(chuàng)手術(shù)方法,具有手術(shù)創(chuàng)傷小,術(shù)后恢復(fù)快,術(shù)后疼痛輕,住院時間短,切口瘢痕小等優(yōu)點(diǎn),已越來越多地應(yīng)用在子宮切除手術(shù)方面。生存質(zhì)量作為新興的對患者生活方面和人生充實感等各個方面總體地、客觀地對患者的評價,作為患者治療后生理和心理方面的綜合評價標(biāo)準(zhǔn),已經(jīng)受到越來越多的關(guān)注。為綜合評價宮頸癌患者腹腔鏡術(shù)后的生存質(zhì)量,及各種不同因素下患者的生存質(zhì)量的差別,特作此調(diào)查研究。 研究目的 評估宮頸癌患者腹腔鏡手術(shù)后的生存質(zhì)量 研究方法 采用流行病學(xué)橫斷面研究的方法,對2010年1月至2013年12月在山東大學(xué)第二附屬醫(yī)院婦產(chǎn)科完成治療的FIGO Ⅰ-Ⅱ期宮頸癌患者進(jìn)行問卷調(diào)查。選用歐洲癌癥研究與治療組織(European Organization for Research and Treatment of Cancer, EORTC)的生存質(zhì)量核心量表中文版Quality of Life Core Questionaire, QLQ-C30(V3.0)和生存質(zhì)量測量表之宮頸癌模塊中文版(Cervix Cancer Module, EORTC QLQ-CX24)作為調(diào)查問卷。通過電話和郵件隨訪的方式取得生存質(zhì)量問卷結(jié)果。并按照EORTC提供的計算方法與評分標(biāo)準(zhǔn),對結(jié)果進(jìn)行分析描述。同時,按照隨訪時間、FIGO分期及年齡3個因素對生存質(zhì)量調(diào)查結(jié)果進(jìn)行分組,使用非參數(shù)秩和檢驗進(jìn)行統(tǒng)計學(xué)分析各組間結(jié)果的顯著性差異。 結(jié)果 在平均隨訪時間為21.3個月,范圍為6.7-44.6個月中,整體健康的生活質(zhì)量評分較高,表示治療后患者具有良好的總體生存質(zhì)量。睡眠障礙、疲勞與食欲不振,更年期癥狀及周圍神經(jīng)癥狀評分稍高,表示略有不適,最嚴(yán)重的癥狀是性功能影響,其余條目評分均較低,表示其余癥狀均不明顯。生存質(zhì)量調(diào)查的結(jié)果與隨訪時間、FIGO分期及年齡3個因素的關(guān)系分析,結(jié)果顯示絕大部分條目無顯著性差異,僅在角色功能、認(rèn)知功能、睡眠障礙、身體形象、總體健康和性憂慮方面,年齡與生存質(zhì)量結(jié)果存在影響關(guān)系,其中只有性憂慮方面影響較大,其他項目影響較為輕微。 結(jié)論 宮頸癌患者腹腔鏡術(shù)后整體生存質(zhì)量良好,僅在睡眠障礙、疲勞與食欲不振及更年期癥狀方面略有不適,突出表現(xiàn)為性功能影響嚴(yán)重。同時,年齡與生存質(zhì)量結(jié)果在角色功能、認(rèn)知功能、總體健康和性憂慮方面存在影響關(guān)系。
[Abstract]:Research background. Cervical cancer is the most common malignant tumor of female genital tract in gynecology. There are no obvious symptoms and signs in the early stage of the disease, vaginal bleeding can occur in the later stage, the etiology is not fully understood, and the age distribution of the disease is widespread. The prognosis of patients with lymphatic metastasis is poor. In recent decades, the universal application of cervical cytological screening has enabled the early detection and treatment of cervical cancer and precancerous lesions. The incidence and mortality of cervical cancer have decreased significantly. Laparoscopic surgery is a newly developed minimally invasive surgical method with the advantages of small trauma, quick postoperative recovery, light postoperative pain, short hospital stay, small incision scar, and so on. The quality of life, as a newly emerging aspect of the patient's life and a sense of fulfillment in life, has been used more and more in hysterectomy. As a whole, the quality of life objectively evaluates the patient. As a comprehensive evaluation standard of physiology and psychology after treatment, more and more attention has been paid to the comprehensive evaluation of the quality of life of patients with cervical cancer after laparoscopic surgery, and the difference of quality of life among patients with different factors. This investigation is hereby carried out. Research purpose. Evaluation of quality of life in patients with cervical cancer after laparoscopic surgery. Research method. Using the method of epidemiological cross-sectional study, From January 2010 to December 2013, a questionnaire survey was conducted on FIGO stage 鈪，

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