Berndtsson Ina, Lindholm Elisabet, Oresland Tom, Börjesson Lars
The Colorectal Unit, Sahlgrenska University Hospital/Ostra, S-416 85, Göteborg, Sweden.
Dis Colon Rectum. 2007 Oct;50(10):1545-52. doi: 10.1007/s10350-007-0278-6.
This study was designed to investigate long-term pouch function and health-related quality of life in a single, large cohort of patients with ileal pouch-anal anastomosis for ulcerative colitis.
Data from 370 patients were included in the study. Thirty-nine patients (11 percent) did not have a functioning pouch (failures) but were included in the health-related quality of life analyses. Pouch function (Oresland score) and health-related quality of life (Short Form-36) were evaluated by postal questionnaires. A total of 88 percent of the patients with a functioning ileal pouch-anal anastomosis returned the questionnaires vs. 76 percent of the failures. Median follow-up time after ileal pouch-anal anastomosis was 15 years vs. 11 years after failure. An age-matched and gender-matched reference sample (n = 286) was randomly drawn from the Swedish Short Form-36 database.
Median bowel frequency was six per 24 hours: 76 percent emptied the reservoir at night, 23 percent had urgency, 12 percent had evacuation difficulties, and 17 percent experienced soiling during the day. Fifty-two percent of the males and 32 percent of the females suffered from soiling at night. More than one-half of the patients had occasional perianal soreness, 6 percent considered the pouch to be a social handicap, and 94 percent were satisfied with their pouch. Patients with a functioning ileal pouch-anal anastomosis did not differ from the reference sample on any Short Form-36 domain, except for a reduced score in General Health (P = 0.02). Pouch function was positively correlated to health-related quality of life. Patients with pouch failure had reduced health-related quality of life in most domains.
Patients' satisfaction is high and functional outcome is good after ileal pouch-anal anastomosis. Poor pouch function affects health-related quality of life negatively. Patients with failure after ileal pouch-anal anastomosis are substantially limited in a variety of health-related quality of life domains.
本研究旨在调查一大群接受回肠储袋肛管吻合术治疗溃疡性结肠炎患者的长期储袋功能及与健康相关的生活质量。
本研究纳入了370例患者的数据。39例患者（11%）储袋功能丧失（失败组），但纳入了与健康相关的生活质量分析。通过邮寄问卷评估储袋功能（奥雷斯兰评分）和与健康相关的生活质量（简明健康状况调查量表36项）。回肠储袋肛管吻合术功能正常的患者中，共有88%回复了问卷，而失败组的回复率为76%。回肠储袋肛管吻合术后的中位随访时间为15年，失败组为11年。从瑞典简明健康状况调查量表36项数据库中随机抽取年龄和性别匹配的对照样本（n = 286）。
排便频率中位数为每24小时6次：76%的患者夜间排净储袋，23%有便急，12%有排便困难，17%白天有污粪。52%的男性和32%的女性夜间有污粪。超过一半的患者偶尔有肛周疼痛，6%认为储袋造成社交障碍，94%对其储袋满意。除一般健康领域得分降低外（P = 0.02），回肠储袋肛管吻合术功能正常的患者在简明健康状况调查量表36项的任何领域与对照样本均无差异。储袋功能与健康相关生活质量呈正相关。储袋功能失败的患者在大多数领域的健康相关生活质量降低。
回肠储袋肛管吻合术后患者满意度高，功能结果良好。储袋功能差对健康相关生活质量有负面影响。回肠储袋肛管吻合术失败的患者在各种健康相关生活质量领域受到很大限制。
