Betchen Simone A, Walsh Jane, Post Kalmon D
Department of Neurosurgery, Mount Sinai School of Medicine, New York, New York, USA.
J Neurosurg. 2003 Nov;99(5):818-23. doi: 10.3171/jns.2003.99.5.0818.
The aim of this study was to determine if factors such as postoperative hearing, facial function, headaches, or other factors have an impact on self-assessed quality of life (QOL) after acoustic neuroma surgery.
The SF-36 and seven additional questions on the impact of surgery on the QOL were sent to 135 consecutive patients who had undergone acoustic neuroma surgery. The Spearman rho correlations were calculated for each of the eight categories of the SF-36 (general health, physical functioning, physical role limitations, emotional role limitations, mental health, energy/vitality, pain, social functioning). The results were correlated with patients' sex, age, persistent headache, years since surgery, postoperative hearing level, and facial function. The response rate was 74.8%. The transformed scores of the eight categories of the SF-36 were lower than age-matched healthy controls in approximately half of the categories. The strongest trend toward lower scores with statistical significance in two categories was persistent headaches. Some categories demonstrated trends toward lower scores with females or age older than 55 years. Postoperative hearing and facial functioning, and time since surgery showed no statistically significant impact on QOL measured by the SF-36. Responses to the additional questions indicate that hearing, facial function, and headache influenced people's feelings about surgery and had an impact on their return to work.
The QOL scores are not consistently lower than population normative values compared with different normative studies. The strongest correlation was between the presence of persistent headache and QOL. Other correlations were not consistent in all categories, and few were statistically significant. These trends in some categories do not explain the difference seen between patients after acoustic neuroma surgery in this study and normal populations in other studies.
本研究旨在确定术后听力、面部功能、头痛或其他因素是否会对听神经瘤手术后自我评估的生活质量(QOL)产生影响。
向135例连续接受听神经瘤手术的患者发送了SF-36问卷以及另外七个关于手术对生活质量影响的问题。对SF-36的八个类别(总体健康、身体功能、身体角色限制、情感角色限制、心理健康、精力/活力、疼痛、社会功能)分别计算斯皮尔曼等级相关系数。将结果与患者的性别、年龄、持续性头痛、术后年限、术后听力水平和面部功能进行关联。回复率为74.8%。SF-36八个类别的转换分数在大约一半的类别中低于年龄匹配的健康对照组。在两个类别中,得分降低且具有统计学意义的最强趋势是持续性头痛。一些类别显示女性或年龄大于55岁的患者得分有降低趋势。术后听力和面部功能以及术后时间对SF-36测量的生活质量没有统计学上的显著影响。对附加问题的回答表明,听力、面部功能和头痛会影响人们对手术的感受,并对他们的重返工作产生影响。
与不同的规范性研究相比,生活质量评分并不总是低于人群规范值。持续性头痛与生活质量之间的相关性最强。其他相关性在所有类别中并不一致,且很少有统计学意义。本研究中这些类别中的趋势并不能解释听神经瘤手术后患者与其他研究中的正常人群之间的差异。