Department of Obstetrics and Gynaecology, Clinical Science, Malmö University Hospital, Lund University, S-205 02 Malmö, Sweden.
Eur J Obstet Gynecol Reprod Biol. 2009 Dec;147(2):221-5. doi: 10.1016/j.ejogrb.2009.09.002. Epub 2009 Sep 25.
To evaluate the long-term impact on quality of life (QoL) in women referred for colposcopy after an abnormal cervical smear.
One hundred consecutive women referred for colposcopy for the first time subsequent to receiving notification of an abnormal cervical smear. Women in the study group completed the Swedish Health Survey Short Form-36 (SF-36), the State/Trait Anxiety Inventory (STAI, Form Y), and the Montgomery Asberg Depression Rating Scale, Self-rate (MADRS-S). The women had follow-up visits at 6 months and 2 years.
The baseline mean for the mental component summary score and for all mental subscale scores on the SF-36 were statistically significantly lower than Swedish normative data for women. At the end of 2 years, the mental component summary scale and vitality were still significantly lower than such data. There were no differences in QoL between women having had treatment with Large Loop Excision of the Transformation Zone (LLETZ) compared to those who did not. When studied separately, non-depressed women felt no impact on QoL whereas women with higher depression scores judged their mental health QoL worse.
Women experienced long-lasting negative effects on their mental health, but not on their physical health after referral for colposcopy. LLETZ had no measurable influence on QoL at any of the visits. This indicates that it is not the severity of the lesions or the treatment itself that affects women but the fact of having had an abnormal cervical smear identified. Depressive mood may be a major variable for the perception of low QoL.
评估因宫颈涂片异常而转介行阴道镜检查的女性长期生活质量(QoL)的影响。
100 例首次因宫颈涂片异常而转介行阴道镜检查的连续女性。研究组女性完成了瑞典健康调查短表 36 项(SF-36)、状态/特质焦虑量表(STAI,Y 型)和蒙哥马利抑郁评定量表,自我评定(MADRS-S)。这些女性在 6 个月和 2 年时进行了随访。
SF-36 心理成分综合评分和所有心理子量表评分的基线平均值均明显低于瑞典女性的常模数据。2 年后,心理成分综合评分和活力仍然明显低于这些数据。接受大环形电切术(LLETZ)治疗的女性与未接受治疗的女性之间的 QoL 无差异。单独研究时,无抑郁的女性认为 QoL 没有受到影响,而抑郁评分较高的女性则认为自己的心理健康 QoL 更差。
女性在阴道镜检查转介后经历了长期的心理健康负面影响,但对身体健康没有影响。在任何随访中,LLETZ 对 QoL 均无明显影响。这表明影响女性的不是病变的严重程度或治疗本身,而是发现宫颈涂片异常的事实。抑郁情绪可能是感知 QoL 低的一个重要变量。