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胸腹主动脉瘤修复长期幸存者的健康相关生活质量

Health-related quality of life in long term-survivors of thoracoabdominal aortic aneurysm repair.

作者信息

Eide Trine M Olberg, Romundstad Pål, Klepstad Pål, Myhre Hans O

机构信息

Department of Surgery, University Hospital of Trondheim, Trondheim, Norway.

出版信息

J Vasc Nurs. 2005 Sep;23(3):88-94; quiz 95. doi: 10.1016/j.jvn.2005.06.002.

Abstract

The purpose was to assess health-related quality of life (HRQOL) in long-term survivors of thoracoabdominal aneurysm repair. Between 1983 and 2001, 43 patients underwent thoracoabdominal aneurysm repair. Long-term survivors (13) were investigated. Two were lost to follow-up. The mean follow-up period was 6.2 years. HRQOL was measured by Short Form (SF)-36, constructed of 36 items grouped into eight scales measuring physical functioning, role limitations caused by physical problems, bodily pain, general health perceptions, vitality, social functioning, role limitations caused by emotional problems, and mental health. Additional questions specific for vascular disease were ascribed. The patients' relatives received corresponding questions, responding on behalf of the patients. Patient data scores were compared with a selection of individuals from the general population. The patients' SF-36 scores were generally poorer than that of the healthy population in both physical and mental dimensions. Patients who had a complicated postoperative course generally scored lowest in physical dimensions. Comparing patients' scores with relatives scoring on behalf of the patients showed no statistical differences. According to disease-specific questions, impotence and pain were reported as major long-term postoperative problems. Patients with uncomplicated postoperative courses all reported improved health status (six) compared with the preoperative status, whereas five patients with complicated postoperative courses reported poorer health status. Nine of 11 patients experienced the same or improved HRQOL, and two patients reported reduced HRQOL after surgery. Ten of 11 patients evaluated the operation as successful. Although the sample size in this study is small, those who had postoperative complications or reported a decreased physical function in the years after surgery generally had low scores in almost all dimensions of the SF-36. When disease-specific questions were related to thoracoabdominal aneurysm surgery, most patients reported an acceptable HRQOL.

摘要

目的是评估胸腹主动脉瘤修复术长期存活者的健康相关生活质量(HRQOL)。1983年至2001年间,43例患者接受了胸腹主动脉瘤修复术。对长期存活者(13例)进行了调查。2例失访。平均随访期为6.2年。HRQOL采用简短健康调查问卷(SF-36)进行测量,该问卷由36个项目组成,分为八个量表,分别测量身体功能、身体问题导致的角色受限、身体疼痛、总体健康感知、活力、社会功能、情绪问题导致的角色受限以及心理健康。还添加了针对血管疾病的特定问题。患者亲属收到相应问题,代表患者作答。将患者数据得分与从普通人群中选取的个体进行比较。患者的SF-36得分在身体和心理维度上总体均低于健康人群。术后病程复杂的患者在身体维度上得分通常最低。将患者得分与亲属代表患者的得分进行比较,未发现统计学差异。根据疾病特定问题,阳痿和疼痛被报告为主要的术后长期问题。术后病程无并发症的患者均报告健康状况较术前有所改善(6例),而5例术后病程复杂的患者报告健康状况较差。11例患者中有9例经历了相同或改善的HRQOL,2例患者报告术后HRQOL降低。11例患者中有10例认为手术成功。尽管本研究样本量较小,但术后出现并发症或术后数年报告身体功能下降的患者,其SF-36几乎所有维度的得分通常都较低。当疾病特定问题与胸腹主动脉瘤手术相关时,大多数患者报告HRQOL可接受。

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