Department of Gastrointestinal Surgery, Oslo University Hospital, Aker, Norway.
Colorectal Dis. 2011 Apr;13(4):431-7. doi: 10.1111/j.1463-1318.2009.02163.x.
The study aimed to evaluate long-term health-related quality of life (HRQOL) and functional outcome in patients who had undergone restorative proctocolectomy with ileo-anal anastomosis (IPAA) for ulcerative colitis and familial adenomatous polyposis.
A total of 156 patients who underwent IPAA during the period 1984-2003 and who still had an intact pouch were included. The HRQOL score was compared with 4152 individuals from the general Norwegian population using the SF-36 questionnaire, and function was evaluated using the Wexner Continence Grading Scale.
One hundred and ten (71%) patients answered the questionnaires, 60 (55%) of whom were men. All except five patients had ulcerative colitis. Median (range) age at interview was 47 (19-66) years, and time after surgery was 12 (2-22) years. The IPAA patients scored slightly, but significantly, lower in four of six SF-36 health domains than the control subjects, adjusted for age and gender. Multiple regression analysis showed frequency of nocturnal defaecation, faecal incontinence and urgency to be independent negative prognostic factors of quality of life. Frequency of defaecation was a median of 7 (3-12) bowel movements during the day and 2 (0-6) at night. The majority had some degree of faecal incontinence, median (range) Wexner score of 8 (0-17), and 40% reported urgency of defaecation necessitating alterations in lifestyle.
Patients with IPAA reported slightly lower HRQOL rates than the general population and had an inferior functional outcome.
本研究旨在评估溃疡性结肠炎和家族性腺瘤性息肉病患者接受直肠结肠切除术和回肠肛管吻合术（IPAA）后的长期健康相关生活质量（HRQOL）和功能结局。
共纳入 156 例 1984-2003 年期间接受 IPAA 且仍保留完整储袋的患者。使用 SF-36 问卷将 HRQOL 评分与 4152 名普通挪威人群进行比较，并使用 Wexner 失禁分级量表评估功能。
110 例（71%）患者回答了问卷，其中 60 例（55%）为男性。除 5 例患者外，其余均患有溃疡性结肠炎。访谈时的中位（范围）年龄为 47（19-66）岁，术后时间为 12（2-22）年。除年龄和性别外，IPAA 患者在六个 SF-36 健康领域中的四个领域的评分略低，但具有统计学意义。多变量回归分析显示，夜间排便频率、粪便失禁和排便急迫感是生活质量的独立负面预后因素。排便频率中位数为每天 7（3-12）次，夜间 2（0-6）次。大多数患者有一定程度的粪便失禁，Wexner 评分中位数（范围）为 8（0-17），40%的患者报告有排便急迫感，需要改变生活方式。
接受 IPAA 的患者报告的 HRQOL 率略低于普通人群，且功能结局较差。
