Keeling Aoife N, Naughton Peter A, O'Connell AnnaMarie, Lee Michael J
Department of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
J Vasc Interv Radiol. 2008 Feb;19(2 Pt 1):169-76. doi: 10.1016/j.jvir.2007.09.003.
To prospectively assess the impact of peripheral percutaneous transluminal angioplasty (PTA) on quality of life (QOL) in patients with intermittent claudication or critical limb ischemia (CLI). The secondary purpose was to determine if periprocedural medication altered patient QOL.
A total of 72 patients underwent lower-limb PTA (86 lesions) over a period of 12 months. QOL data were obtained before PTA and at 1 and 6 months after PTA with use of the Short Form-36 (SF-36) questionnaire.
The SF-36 questionnaire was completed in 100% of cases before PTA, in 89% at 1 month after PTA, and in 78% at 6 months after PTA. Baseline QOL was worse than the QOL quoted for the normal population. Overall, there was an improvement in QOL in seven of the nine health domains at 1 month after PTA, and the improvements were significant (P < .01) in five. Improvement was demonstrated at 6 months in all nine QOL domains measured, which was significant (P < .01) in five. Patients with intermittent claudication (n = 40) exhibited an improvement in all nine health domains at 6 months, which was significant (P < .05) in seven. The CLI group (n = 32) showed an improvement in five domains at 6 months, which was significant (P < .05) in two. Subjects with intermittent claudication experienced a more significant improvement than those with CLI. SF-36 pain scores at 1 month after PTA were significantly better in patients taking aspirin than in those who were not (P < .001).
PTA results in improved QOL in patients with intermittent claudication and CLI as early as 1 month, which was shown to be maintained at 6 months in our small series. Aspirin significantly improves pain after PTA. QOL assessment is useful after peripheral angioplasty.
前瞻性评估外周经皮腔内血管成形术(PTA)对间歇性跛行或严重肢体缺血(CLI)患者生活质量(QOL)的影响。次要目的是确定围手术期用药是否会改变患者的生活质量。
在12个月的时间里,共有72例患者接受了下肢PTA(86处病变)。使用简短健康调查问卷(SF-36)在PTA前、PTA后1个月和6个月获取生活质量数据。
100%的病例在PTA前完成了SF-36问卷,89%在PTA后1个月完成,78%在PTA后6个月完成。基线生活质量比正常人群的生活质量差。总体而言,PTA后1个月,九个健康领域中有七个领域的生活质量有所改善,其中五个领域的改善具有统计学意义(P < 0.01)。在测量的所有九个生活质量领域中,6个月时均显示出改善,其中五个领域具有统计学意义(P < 0.01)。间歇性跛行患者(n = 40)在6个月时九个健康领域均有改善,其中七个领域具有统计学意义(P < 0.05)。CLI组(n = 32)在6个月时五个领域有改善,其中两个领域具有统计学意义(P < 0.05)。间歇性跛行患者的改善比CLI患者更显著。PTA后1个月,服用阿司匹林的患者SF-36疼痛评分明显优于未服用阿司匹林的患者(P < 0.001)。
PTA可使间歇性跛行和CLI患者的生活质量早在1个月时就得到改善,在我们的小样本系列中,这种改善在6个月时仍得以维持。阿司匹林可显著改善PTA后的疼痛。外周血管成形术后进行生活质量评估是有用的。