Podolec Piotr, Mura Aleksandra, Rubiś Paweł, Podolec Jakub, Kopeć Grzegorz, Barczyk Edyta, Juszczyk Agnieszka, Pasowicz Mieczysław, Kapelak Bogusław, Sadowski Jerzy, Tracz Wiesława
Klinika Chorób Serca i Naczyń, Instytutu Kardiologii Collegium Medicum, Uniwersytetu Jagiellońskiego, Kraków.
Przegl Lek. 2004;61(6):631-5.
To evaluate quality of life (QoL) in patients after aortic homograft implantation for aortic valve disease and in those who had undergone reoperation due to homograft dysfunction.
QoL was assessed in 354 patients (72 women and 282 men, mean age 55.1 +/- 11.5 years, range 13-69) after aortic homograft implantation. Patients were divided into two groups: I--patients after aortic homograft implantation without reoperation (291 patients) and II--patients after reoperation (68 patients). We used two questionnaires: SF 36 (Short Formulation 36) and a self-developed questionnaire for patients after cardiac operation (SDQ). SF 36 has three levels: a) 36 items; b) eight scales: physical activity, social activity, limitations in every day activity, body pain, mental health, emotional problems, vitality and health perception; c) two summary measures that aggregate scales; general physical health which constitutes of physical activity, limitations in every day activities, body pain, health perception and general mental health which constitutes the rest of four scales: social activity, mental health, emotional problems, vitality. Each scale is standardized from 1 to 100 with > 50 indicating better than general population average. SDQ is focused on social and demographic factors, clinical symptoms before and after operation, risk factors and physical and occupational activity.
By SF 36, only health perception was below general population average. We found a statistically positive relationship between QoL and high physical and occupational activity in both groups (p<0.05). The presence of dyspnea, chest pain, palpitations, edema, faints, fear/anxiety and hypertension were related to decreased general physical and mental health in both groups (p<0.05).
Patients after aortic homograft implantation have high QoL. This holds also for those after reoperation for homograft dysfunction. Symptomatic patients have lower QoL. Higher QoL is associated with physical and occupational activity. There is no difference in general physical health in both groups. General mental health is decreased in reoperated patients. Since reoperated patients more often suffer from emotional problems, they may particularly benefit from the psychological support.
评估主动脉瓣疾病患者行主动脉同种异体移植术后以及因同种异体移植功能障碍而接受再次手术患者的生活质量（QoL）。
对354例主动脉同种异体移植术后患者（72例女性，282例男性，平均年龄55.1±11.5岁，范围13 - 69岁）的生活质量进行评估。患者分为两组：I组——主动脉同种异体移植术后未接受再次手术的患者（291例）和II组——接受再次手术的患者（68例）。我们使用了两份问卷：SF 36（简明健康状况调查问卷36项）和一份自行编制的心脏手术后患者问卷（SDQ）。SF 36有三个层面：a）36个条目；b）八个维度：身体活动、社会活动、日常活动受限、身体疼痛、心理健康、情绪问题、活力和健康感知；c）两个汇总测量指标，用于汇总各维度得分；总体身体健康，由身体活动、日常活动受限、身体疼痛、健康感知组成，以及总体心理健康，由其余四个维度组成：社会活动、心理健康、情绪问题、活力。每个维度的评分范围为1至100，得分>50表明优于一般人群平均水平。SDQ关注社会和人口统计学因素、手术前后的临床症状、危险因素以及身体和职业活动。
根据SF 36，仅健康感知低于一般人群平均水平。我们发现两组患者的生活质量与较高的身体和职业活动之间存在统计学上的正相关关系（p<0.05）。两组中出现呼吸困难、胸痛、心悸、水肿、晕厥、恐惧/焦虑和高血压均与总体身心健康下降有关（p<0.05）。
主动脉同种异体移植术后患者的生活质量较高。对于因同种异体移植功能障碍而接受再次手术的患者也是如此。有症状的患者生活质量较低。较高的生活质量与身体和职业活动相关。两组患者的总体身体健康状况无差异。再次手术患者的总体心理健康状况下降。由于再次手术患者更常出现情绪问题，他们可能特别受益于心理支持。
