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梅尼埃病患者鼓室内注射链霉素后生活质量的评估。

Evaluation of quality of life after intratympanic streptomycin injection in patients with Ménière's disease.

作者信息

Jung Jinsei, Chun Jeyoung, Kim Nahyun, Kim Younghoon, Lee Won-Sang

机构信息

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea.

出版信息

Otol Neurotol. 2008 Sep;29(6):816-23. doi: 10.1097/MAO.0b013e31817ef4e3.

Abstract

OBJECTIVES

Quality of life (QOL) and satisfaction level of patients with Ménière's disease who underwent intratympanic streptomycin injection were evaluated across physical, psychological, and social domains of function.

STUDY DESIGN

Preoperative and postoperative QOL of patients were evaluated based on the chart records of patients and questionnaire surveys. From January 2000 to August 2005, 81 patients underwent intratympanic streptomycin injection at Yonsei University Severance Hospital, and their medical records were retrospectively reviewed. In addition, a mailed questionnaire survey was conducted. Ménière's Disease Outcome Questionnaire-Retrospective Version, proposed by Kato et al., was used as the QOL measure and was completed by 51 patients.

RESULTS

The average QOL score was 35.6 +/- 9.6 before surgery and 52.8 +/- 10.3 after surgery, indicating improvement of QOL by 17.2 after surgery. The improvement of QOL score did not correlate to age and sex of patients; nonetheless, higher improvement of score was found in patients with professional career (p < 0.001). The improvement of QOL in the preoperative Stage 3 and 4 patient groups was greater than that in the preoperative Stage 1 and 2 patient groups (p = 0.032). The mean change in hearing of the patients after surgery was 1.5 + 7.2 dB hearing loss based on a 4-frequency pure-tone average (500, 1,000, 2,000, 3,000 Hz). Furthermore, 4 (7.8%) of 51 patients demonstrated greater than 10-dB change in 4-frequency pure-tone average. The status of hearing loss after surgery did not influence the QOL score (p = 0.530). As the frequency of vertigo decreased, the improvement of QOL score increased (p = 0.042).

CONCLUSION

The level of satisfaction with intratympanic streptomycin injection was strongly correlated to the QOL score in Ménière's Disease Outcome Questionnaire-Retrospective Version. As for the factors that improved the QOL after surgery, the status of hearing was not closely associated; however, the frequency of vertiginous symptom was the most important factor.

摘要

目的

对接受鼓室内注射链霉素治疗的梅尼埃病患者的生活质量(QOL)及满意度水平进行身体、心理和社会功能领域的评估。

研究设计

基于患者病历记录及问卷调查对患者术前和术后的生活质量进行评估。2000年1月至2005年8月,81例患者在延世大学Severance医院接受鼓室内注射链霉素治疗,对其病历进行回顾性分析。此外,还进行了邮寄问卷调查。采用Kato等人提出的梅尼埃病结果问卷回顾版作为生活质量评估指标,51例患者完成了该问卷。

结果

术前生活质量平均得分为35.6±9.6,术后为52.8±10.3,表明术后生活质量提高了17.2。生活质量得分的提高与患者年龄和性别无关;然而,在职患者得分提高更显著(p<0.001)。术前3期和4期患者组生活质量的改善大于术前1期和2期患者组(p=0.032)。术后患者基于4频率纯音平均(500、1000、2000、3000Hz)的听力平均变化为听力损失1.5+7.2dB。此外,51例患者中有4例(7.8%)4频率纯音平均变化大于10dB。术后听力损失状况不影响生活质量得分(p=0.530)。随着眩晕发作频率降低,生活质量得分提高(p=0.042)。

结论

在梅尼埃病结果问卷回顾版中,鼓室内注射链霉素的满意度水平与生活质量得分密切相关。至于术后改善生活质量的因素,听力状况并非密切相关;然而,眩晕症状发作频率是最重要的因素。

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