目的研究前列腺癌患者围手术期心理干预和术后生活质量评估的相关性。方法选取107例行前列腺癌根治术的患者,随机分成实验组和对照组,在术前采用焦虑状态一特质评分问卷(the Stata.Trait Anxiety Inventory,STAI)进行焦虑评估;实验组在其围手术期进行心理干预,在术后一个月,对两组采用前列腺癌治疗功能评价(the functional assessment of cancer therapy-prostate,FACT-P)问卷,对其生活质量进行调查,对患者的术前焦虑和术后生活质量评估进行相关性分析。结果两组术前的STAI及其他各项观察指标无显著性差异(P〉0.05),术后实验组的FACT-P评分较对照组有显著性差异(尸〈0.05),实验组的术后生活质量明显优于对照组,其中情感状况的分值有显著差异(P〈0.05)。结论前列腺癌患者的围手术期心理干预有助于术后生活质量。在手术前根据焦虑评分状况制定围手术期的心理干预,对临床治疗及术后恢复具有积极的意义。
Background Over the past two decades,the clinical presentation of renal masses has evolved,where the rising incidence of small renal masses (SRMs) and concomitant minimal invasive treatments have led to noteworthy changes in paradigm of kidney cancer.This study was to perform a proportional meta-analysis of observational studies on perioperative complications and oncological outcomes of partial nephrectomy (PN) and radiofrequency ablation (RFA).Methods The US National Library of Medicine's life science database (Medline) and the Web of Science were exhaustly searched before August 1,2013.Clinical stage 1 SRMs that were treated with PN or RFA were included,and perioperative complications and oncological outcomes of a total of 9 565 patients were analyzed.Results Patients who underwent RFA were significantly older (P <0.001).In the subanalysis of stage T1 tumors,the major complication rate of PN was greater than that of RFA (laparoscopic partial nephrectomy (LPN)/robotic partial nephrectomy (RPN):7.2%,open partial nephrectomy (OPN):7.9%,RFA:3.1%,both P <0.001).Minor complications occurred more frequently after RFA (RFA:13.8%,LPN/RPN:7.5%,OPN:9.5%,both P <0.001).By multivariate analysis,the relative risks for minor complications of RFA,compared with LPN and OPN,were 1.7-fold and 1.5-fold greater (both P <0.01),respectively.Patients treated with RFA had a greater local progression rate than those treated by PN (RFA:4.6%,LPN/RPN:1.2%,OPN:1.9%,both P <0.001).By multivariate analysis,the local tumor progression for RFA versus LPN/RPN and OPN were 4.5-fold and 3.1-fold greater,respectively (both P <0.001).Conclusions The current data illustrate that both PN and RFA are viable strategies for the treatment of SRMs.Compared with PN,RFA showed a greater risk of local tumor progression but a lower major complication rate,which is considered better for poor candidates.PN is with no doubt the golden treatment for SRMs,and LPN h
目的:研究前列腺癌患者术前焦虑和术后生活质量评估的相关性。方法选取32例行前列腺癌根治术的患者,在其术前1d,采用焦虑状态-特质评分问卷(the Stata-Trait Anxiety Inventory,STAI)进行焦虑评估;在术后1个月,采用前列腺癌治疗功能评价(the functional assessment of cancer therapy-prostate, FACT-P)问卷,对其生活质量进行调查。通过SPSS软件对患者的术前焦虑和术后生活质量评估进行相关性分析。结果患者的术前焦虑评分为59.0±7.3,术后生活质量评估为64.5±7.4。术前焦虑和术后生活质量评估呈线性负相关关系(r=-0.58,P<0.05)。结论前列腺癌患者的术前焦虑和术后生活质量评分呈负相关关系,根据焦虑评分状况积极地进行围手术期的心理干预,加强患者与家人朋友的沟通交流,对临床治疗及术后恢复具有积极的意义。