摘要
目的探究人乳头瘤病毒(HPV)感染、不同级别宫颈鳞状上皮内病变(SIL)及治疗妇女的生命质量。方法对2017年6月至2018年12月在山西省襄垣县和阳城县、内蒙古鄂托克旗及深圳市建立的宫颈癌筛查队列中符合标准的24~69岁妇女7034例进行调查,其中接受宫颈环形电切术(LEEP)和热凝治疗者均为93例。于2021年3月3日至4月12日采用五水平欧洲五维健康量表(EQ-5D-5L)开展问卷调查。该量表包括健康描述系统和视觉模拟(VAS)两部分,其中健康描述系统可换算为健康效用值。对不同病变程度及不同治疗方式患者治疗前后的健康效用值和VAS评分进行组间差异分析。结果对治疗前病变程度的调查显示,高级别上皮内病变(HSIL)导致妇女的健康效用值分值降低(P<0.05);HPV感染、低级别上皮内病变(LSIL)和HSIL导致其VAS评分下降(P均<0.05)。对于治疗方式的调查显示,LEEP治疗后1个月内妇女在“行动能力”、“日常活动”和“疼痛或不适”3个维度的困难率较治疗前显著增加【治疗前困难率分别为0%(0/93)、2.2%(2/93)和11.8%(11/93);治疗后分别为7.5%(7/93)、10.8%(10/93)和25.8%(24/93);P均<0.05】,健康效用值分值降低(治疗前0.985±0.041;治疗后0.957±0.094;P<0.01)。热凝治疗后1个月内妇女的VAS评分【治疗前(87.763±11.297)分;治疗后(90.290±10.001)分;P<0.05】显著改善。结论HPV感染和宫颈SIL导致妇女生命质量降低。热凝治疗对短期生命质量的影响低于LEEP。
Objective To explore the quality of life(QOL)in human papillomavirus(HPV)infection and squamous intraepithelial lesion(SIL)women,as well as those undergoing treatment.Methods 7034 eligible women aged 24-69years were enrolled in this study from a cervical cancer screening project conducted in Xiangyuan and Yangcheng counties in Shanxi Province,Etuoke counties in Inner Mongolia,and Shenzhen from June 2017 to December 2018.93 participants underwent loop electrical excision procedure(LEEP)and 93 underwent thermal ablation.The Chinese version of the fivelevel EuroQol five-dimensional questionnaire(EQ-5D-5L)was used to conduct the survey from March 3 to April 12,2021.This questionnaire comprises a short descriptive system questionnaire and a visual analogue scale(VAS),and the descriptive system can be converted as the health utility.Health utility scores and VAS scores were analyzed in women with different lesion levels before and after treatment.Results The investigation of the different lesions before treatment showed that high-grade squamous intraepithelial lesion(HSIL)led to lower health utility scores(P<0.05);HPV infection,low-grade squamous intraepithelial lesion(LSIL),and HSIL led to lower VAS scores(all P<0.05).The investigation of treatment showed that after LEEP,the rates of women reporting health problems in dimensions of“Mobility”,“Usual-activities”,and“Pain/Discomfort”increased[Before 0%(0/93);2.2%(2/93);11.8%(11/93);After 7.5%(7/93);10.8%(10/93);25.8%(24/93);all P<0.05],and the health utility scores decreased(Before 0.985±0.041;After 0.957±0.094;P<0.01).The VAS score was improved in women treated with thermal ablation(Before 87.763±11.297;After 90.290±10.001;P<0.05).Conclusions HPV infection and SIL lead to reduced QOL in women.In terms of their short-term QOL,thermal ablation may be a better treatment option than LEEP.
作者
文天萌
赵爽
赵雪莲
胡尚英
张勇
赵方辉
WEN Tianmeng;ZHAO Shuang;ZHAO Xuelian;HU Shangying;ZHANG Yong;ZHAO Fanghui(Department of Epidemiology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Clinical Trial Research Center,Beijing Hospital,Beijing 100730,China)
出处
《中国妇产科临床杂志》
CSCD
2023年第2期144-148,共5页
Chinese Journal of Clinical Obstetrics and Gynecology
基金
国家自然科学基金(81761128006)
美国中华医学基金会卫生政策与体系科学公开竞标项目(16-255)。
关键词
宫颈上皮内病变
人乳头瘤病毒
热凝
治疗
生命质量
squamous intraepithelial lesion
human papillomavirus
thermal ablation
treatment
quality of Life
