Moy M L, Ingenito E P, Mentzer S J, Evans R B, Reilly J J
Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Chest. 1999 Feb;115(2):383-9. doi: 10.1378/chest.115.2.383.
To evaluate changes in health-related quality of life (HRQL) as assessed by the Medical Outcomes Study Short Form 36-item questionnaire (SF-36) after pulmonary rehabilitation and lung volume reduction surgery (LVRS).
Prospective cohort study.
Nineteen patients with severe emphysema who underwent pulmonary rehabilitation in preparation for LVRS.
Pulmonary rehabilitation followed by bilateral sequential LVRS.
HRQL assessed by the SF-36 was measured at baseline, after pulmonary rehabilitation, and 6 months after LVRS. One-way analysis of variance with repeated measures demonstrated no significant change from baseline in any of the eight domains after pulmonary rehabilitation. Scores for only one domain, vitality, improved significantly after LVRS compared with scores after pulmonary rehabilitation. However, significant improvements over baseline scores were demonstrated after combined preoperative pulmonary rehabilitation and LVRS in the domains of physical functioning, role limitations due to physical problems, social functioning, and vitality. Pulmonary rehabilitation contributed most to the overall improvements in role limitations due to physical problems, whereas LVRS contributed mainly to the overall improvements in physical functioning, social functioning, and vitality.
Patients with severe emphysema experience significant improvements in both physical and social health status as assessed by the SF-36 after combined pulmonary rehabilitation and LVRS. Each intervention makes unique and complementary contributions to the overall improvements in HRQL.
通过医学结局研究简明健康调查问卷(SF - 36)评估肺康复和肺减容手术(LVRS)后健康相关生活质量(HRQL)的变化。
前瞻性队列研究。
19例重度肺气肿患者,为接受LVRS而进行肺康复。
肺康复后行双侧序贯LVRS。
采用SF - 36在基线、肺康复后及LVRS后6个月评估HRQL。重复测量的单因素方差分析显示,肺康复后八个领域中的任何一个领域与基线相比均无显著变化。与肺康复后的得分相比,仅活力这一领域在LVRS后有显著改善。然而,术前肺康复联合LVRS后,在身体功能、因身体问题导致的角色限制、社会功能和活力等领域与基线得分相比有显著改善。肺康复对因身体问题导致的角色限制的总体改善贡献最大,而LVRS主要对身体功能、社会功能和活力的总体改善有贡献。
通过SF - 36评估,重度肺气肿患者在肺康复联合LVRS后,身体和社会健康状况均有显著改善。每种干预措施对HRQL的总体改善都有独特且互补的作用。