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实际活体肝移植供体与潜在活体肝移植供体的身心生活质量:一项前瞻性、对照、多中心研究。

Mental and physical quality of life in actual living liver donors versus potential living liver donors: a prospective, controlled, multicenter study.

机构信息

Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

Liver Transpl. 2009 Dec;15(12):1676-87. doi: 10.1002/lt.21917.

Abstract

In a quasi-experimental design, we investigated the quality of life (QOL) in actual liver donors (n = 43) and potential liver donors (n = 33) before and 3 months after liver transplantation. This is the first study in this field combining a prospective design with an adequate control group. Potential donors served as a control group because they also had a relative in need of a liver transplant and were as emotionally involved with the recipient as actual donors, but they were not subjected to the donor operation. Groups did not differ in age, gender, marital status, donor-recipient relationship, urgency of transplantation, or recipient group (adult versus child). Actual donors showed decreased physical QOL, whereas potential donors were not affected. However, for both groups, a decrease in anxiety was found. Furthermore, actual donors showed a better mental QOL postoperatively than potential donors. The recipients of these 2 groups did not differ with respect to postoperative complications. Furthermore, the groups did not report a different caregiver burden, but actual donors showed higher self-esteem. Because of the surgery, the worsening of physical symptoms in actual donors was expected. It is remarkable, however, that although actual donors still showed a limited physical QOL 3 months after the operation, in both groups, a similar reduction in anxiety could be observed, and actual donors even demonstrated a better mental QOL postoperatively than potential donors. The latter might be due to a psychological benefit that actual donors derived from the fact that they were able to help the recipients.

摘要

在一项准实验设计中,我们调查了实际肝移植供体(n=43)和潜在肝移植供体(n=33)在肝移植前和 3 个月后的生活质量(QOL)。这是该领域首次将前瞻性设计与适当的对照组相结合的研究。潜在供体作为对照组,因为他们的亲属也需要进行肝移植,并且与实际供体一样对受者有情感投入,但他们没有接受供体手术。两组在年龄、性别、婚姻状况、供体-受者关系、移植紧迫性或受者群体(成人与儿童)方面没有差异。实际供体的身体 QOL 下降,而潜在供体则没有受到影响。然而,对于两组,焦虑程度都有所下降。此外,实际供体术后的心理健康状况优于潜在供体。这两组的受者在术后并发症方面没有差异。此外,两组报告的照顾者负担没有差异,但实际供体的自尊心更高。由于手术,实际供体的身体症状恶化是可以预期的。然而,值得注意的是,尽管实际供体在手术后 3 个月仍显示出有限的身体 QOL,但在两组中都观察到焦虑程度相似的降低,实际供体甚至比潜在供体术后的心理健康状况更好。后者可能是由于实际供体能够帮助受者而产生的心理益处。

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