Quintana J M, Aróstegui I, Cabriada J, López de Tejada I, Perdigo L
Unidad de Investigación, Hospital de Galdakao, Galdakao, Spain.
Br J Surg. 2003 Dec;90(12):1549-55. doi: 10.1002/bjs.4345.
Few studies have assessed health-related quality of life (HRQoL) among patients undergoing cholecystectomy. This study aimed to determine clinical variables that predict changes in HRQoL following cholecystectomy.
This was a prospective study of consecutive patients undergoing elective cholecystectomy for gallstones in six hospitals. Patients were asked to complete two questionnaires-the Short Form 36 (SF-36) and the Gastrointestinal Quality of Life Index (GIQLI)-before and 3 months after cholecystectomy. Multivariate linear regression models were used to examine factors potentially contributing to changes in HRQoL.
Patients with symptomatic cholelithiasis and low surgical risk experienced the highest HRQoL gains in several SF-36 and GIQLI domains, with significant improvements in physical function detected by both instruments, compared with asymptomatic individuals at high surgical risk. Patients with asymptomatic cholelithiasis or high surgical risk experienced least improvement.
These data indicate that cholecystectomy is appropriate for patients with symptomatic cholelithiasis and low surgical risk. In terms of HRQoL, the risk to benefit ratio seems poor for patients with asymptomatic gallstones.
很少有研究评估接受胆囊切除术患者的健康相关生活质量(HRQoL)。本研究旨在确定预测胆囊切除术后HRQoL变化的临床变量。
这是一项对六家医院连续接受择期胆囊切除术治疗胆结石患者的前瞻性研究。患者被要求在胆囊切除术前和术后3个月完成两份问卷——简短健康调查问卷(SF-36)和胃肠道生活质量指数(GIQLI)。采用多元线性回归模型来检查可能导致HRQoL变化的因素。
有症状胆结石且手术风险低的患者在几个SF-36和GIQLI领域的HRQoL改善最大,与高手术风险的无症状个体相比,两种工具均检测到身体功能有显著改善。无症状胆结石或高手术风险的患者改善最少。
这些数据表明,胆囊切除术适用于有症状胆结石且手术风险低的患者。就HRQoL而言,无症状胆结石患者的风险效益比似乎不佳。