Yamashiro Shigeo, Nishi Toru, Koga Kazunari, Goto Tomoaki, Muta Daisuke, Kuratsu Jun-ichi, Fujioka Shodo
Department of Neurosurgery, Stroke Center, Saiseikai Kumamoto Hospital, Japan.
J Neurosurg. 2007 Dec;107(6):1086-91. doi: 10.3171/JNS-07/12/1086.
The aim of this study was to assess the quality of life (QOL) of patients who underwent surgery for asymptomatic unruptured intracranial aneurysms (UIAs).
The authors assessed QOL in 149 patients who had undergone microsurgical clipping of asymptomatic UIAs. They surveyed these patients using universal methods such as the 36-Item Short Form Health Survey (SF-36) for health-related QOL and the Hospital Anxiety and Depression Scale for anxiety and depression assessments.
The patients' mean scores for each of the eight domains of SF-36 were comparable to those of a Japanese reference population. Analysis of data from the average-QOL and low-QOL subgroups showed that the low-QOL group contained a higher number of patients with preexisting heart diseases and restricted activities of daily living. Operative procedures and complications did not affect QOL.
Because 86% of the patients who underwent surgery manifested a QOL similar to the reference population, the authors suggest that elective surgery for asymptomatic UIAs is a reasonable treatment, especially in patients who are troubled by the risk of rupture. Postoperative decreases in QOL are not invariably attributable to the operation or its associated complications, but may be correlated with other chronic disorders. To select the appropriate treatment for asymptomatic UIAs, neurosurgeons and patients need information on the expected postoperative QOL.
本研究旨在评估无症状未破裂颅内动脉瘤（UIA）手术患者的生活质量（QOL）。
作者评估了149例接受无症状UIA显微夹闭术患者的生活质量。他们使用通用方法对这些患者进行了调查，如采用36项简明健康调查问卷（SF - 36）评估与健康相关的生活质量，采用医院焦虑抑郁量表评估焦虑和抑郁情况。
患者在SF - 36八个领域的平均得分与日本参考人群相当。对平均生活质量和低生活质量亚组的数据分析表明，低生活质量组中患有既往心脏病且日常生活活动受限的患者数量较多。手术操作和并发症并未影响生活质量。
由于86%接受手术的患者表现出与参考人群相似的生活质量，作者认为无症状UIA的择期手术是一种合理的治疗方法，尤其是对于因破裂风险而困扰的患者。术后生活质量下降并不总是归因于手术或其相关并发症，而可能与其他慢性疾病有关。为了选择适合无症状UIA的治疗方法，神经外科医生和患者需要有关术后预期生活质量的信息。
