Bannerman E, Pendlebury J, Phillips F, Ghosh S
Department of Medical Sciences, The University of Edinbrugh, UK.
Eur J Gastroenterol Hepatol. 2000 Oct;12(10):1101-9. doi: 10.1097/00042737-200012100-00006.
Although gastrostomy feeding tends to have fewer interruptions than naso-gastric feeding and is cosmetically more acceptable; there is little information on health-related quality of life (HRQoL) in these patients. This study aimed to measure the health-related quality of life of patients after gastrostomy placement.
Cross-sectional and prospective cohorts.
Institutional and community-dwelling patients receiving nutritional support via a gastrostomy.
For the cross-sectional cohort, all individuals who have received a percutaneous gastrostomy from our unit (January 1994-December 1996) were included; 55 of the 102 patients who were still living agreed to follow-up assessment. For the prospective cohort, all patients referred to our unit for percutaneous gastrostomy (March 1997-June 1998) were eligible to participate; 54 of 88 patients (62%) consented and were recruited.
A cross-sectional assessment of patient outcome and health-related quality of life using SF-36, the Hospital Anxiety and Depression Scale and a disease-specific questionnaire (PEG-Qu) was carried out in patients in primary health care after receiving a gastrostomy. These assessments, plus the Modified Rankin Scale, were performed on patients studied at the time of gastrostomy placement, and after 1, 6 and 12 months of follow-up.
HRQoL questionnaires could be answered in less than half the patients. An overall rating of the effect of the gastrostomy on the patients' and carers' HRQoL showed a positive effect in 55% and 80%, respectively. A positive impression of the gastrostomy by the patient did not necessarily reflect an improvement in their nutritional status. Assessment of HRQoL in a cohort of gastrostomy patients showed deficiencies in the physical domain but not mental function (anxiety or depression), energy or health perception. Neither physical function nor level of cognition at time of gastrostomy placement appear to be able to predict patient survival. Nutritional outcome was not related to HRQoL outcome.
The majority of patients and carers rate gastrostomy positively. Patients who were 75 years or older had a poorer survival compared to younger patients, but gender, physical or cognitive function had no predictive value on survival.
尽管胃造口喂养比鼻胃管喂养中断次数更少，且在外观上更容易被接受；但关于这些患者与健康相关的生活质量（HRQoL）的信息却很少。本研究旨在测量胃造口术后患者的健康相关生活质量。
横断面和前瞻性队列研究。
通过胃造口接受营养支持的机构和社区居住患者。
横断面队列研究纳入了所有在我们科室接受经皮胃造口术的患者（1994年1月至1996年12月）；102名在世患者中有55名同意接受随访评估。前瞻性队列研究中，所有转诊至我们科室接受经皮胃造口术的患者（1997年3月至1998年6月）均符合参与条件；88名患者中有54名（62%）同意并被纳入研究。
在接受胃造口术的初级卫生保健患者中，使用SF - 36、医院焦虑抑郁量表和特定疾病问卷（PEG - Qu）对患者结局和健康相关生活质量进行横断面评估。这些评估，加上改良Rankin量表，在胃造口术时以及随访1、6和12个月后对研究患者进行。
不到一半的患者能够回答HRQoL问卷。对胃造口术对患者和护理人员HRQoL的总体影响评级显示，分别有55%和80%的患者有积极影响。患者对胃造口术的积极印象不一定反映其营养状况的改善。对一组胃造口术患者的HRQoL评估显示，身体领域存在缺陷，但心理功能（焦虑或抑郁）、精力或健康感知方面没有缺陷。胃造口术时的身体功能和认知水平似乎都无法预测患者的生存情况。营养结局与HRQoL结局无关。
大多数患者和护理人员对胃造口术评价积极。75岁及以上的患者与年轻患者相比生存率较低，但性别、身体或认知功能对生存没有预测价值。
