Franks Peter J, Moffatt Christine J, Doherty Debra C, Smithdale Rachael, Martin Ruth
Centre for Research and Implementation of Clinical Practice, Thames Valley University, London, United Kingdom.
Wound Repair Regen. 2006 Sep-Oct;14(5):536-41. doi: 10.1111/j.1743-6109.2006.00160.x.
Studies that have examined patients' health-related quality of life have consistently shown improvements following intensive and effective treatments over relatively short follow-ups. However, little is known of the longer-term effects of treatment on patients. As part of a study in southwest London, United Kingdom, all patients having a current leg ulcer were examined (n = 113) and those who were able completed the Nottingham Health Profile (n = 95) and were then followed up at 24 and 48 weeks. The patients had a mean age of 76 +/- 13 (SD) years, with 60 (63.2%) being women. Before the study, the ulcer had been present for a median of 8 months (range 0.5-144), and a median area of ulceration of 4.0 cm2 (range 0.5-171.5 cm2). After 24 weeks, there was a significant improvement in pain (mean difference [d] = 9.6, p = 0.002), which was true for both the 41 patients with ulcers present (d=10.07, p = 0.013) and the 43 patients whose ulcers had healed (d = 11.46, p = 0.047). However, after 48 weeks, these improvements had been reduced in both groups (healed ulceration d = 5.76, unhealed patients d = 6.41). Energy, which had improved after 24 weeks in the patients whose ulcers, had healed (d = 11.46), deteriorated in both patient groups after 48 weeks (healed = -5.67, unhealed = -13.43). Mobility status was maintained with healed ulceration (d = 1.05) but deteriorated with unhealed ulceration (d = -13.19). The positive effects of treatment on health-related quality of life may not be sustained over time. This may be a consequence of the general deterioration in the health status of these elderly patients as they age.
对患者健康相关生活质量进行调查的研究一致表明，在相对较短的随访期内，强化有效治疗后患者的生活质量有所改善。然而，对于治疗对患者的长期影响却知之甚少。作为英国伦敦西南部一项研究的一部分，对所有患有腿部溃疡的患者（n = 113）进行了检查，其中能够完成诺丁汉健康量表的患者（n = 95）随后在24周和48周时接受了随访。患者的平均年龄为76±13（标准差）岁，其中60名（63.2%）为女性。在研究开始前，溃疡存在的中位数时间为8个月（范围0.5 - 144个月），溃疡的中位数面积为4.0平方厘米（范围0.5 - 171.5平方厘米）。24周后，疼痛有显著改善（平均差值[d]=9.6，p = 0.002），对于41名溃疡仍存在的患者（d = 10.07，p = 0.013）和43名溃疡已愈合的患者（d = 11.46，p = 0.047）均如此。然而，48周后，两组患者的这些改善都有所减少（愈合溃疡患者d = 5.76，未愈合患者d = 6.41）。溃疡已愈合的患者在24周后精力有所改善（d = 11.46），但48周后两组患者的精力均有所下降（愈合患者d = -5.67，未愈合患者d = - I3.43）。溃疡愈合的患者活动状态得以维持（d = 1.05），但溃疡未愈合的患者活动状态恶化（d = -13.19）。治疗对健康相关生活质量的积极影响可能无法长期持续。这可能是这些老年患者随着年龄增长健康状况普遍恶化的结果。
