Intensive Care Unit, Mercy Hospital, Coon Rapids, Minnesota 55433, USA.
J Cardiovasc Nurs. 2010 Jan-Feb;25(1):25-39. doi: 10.1097/JCN.0b013e3181b99828.
While studies of health-related quality of life (HRQOL) are increasing among cardiovascular patients, very few have examined HRQOL in persons with aortic stenosis (AS).
A critical review of studies (1997-2008) of HRQOL in persons with AS was conducted to summarize findings and identify clinical and research implications.
Twenty-eight studies were identified, all of which were quantitative and evaluated HRQOL after aortic valve replacement (AVR). No studies conducted by nurses or studies measuring HRQOL in persons who did not undergo AVR were found. The literature focused on age and type of valve as variables influencing HRQOL postoperatively. Although results varied, elderly patients often scored similar or better than comparison groups. Health-related quality of life was found to be affected by valve noise and anticoagulation rather than the specific valve type when comparing patients receiving biological versus mechanical valves.
Selection for surgery should not be based on age alone. Early consideration should be given to symptoms prior to surgery because of evidence that patients with fewer symptoms preoperatively have better HRQOL after AVR. Anticoagulation status should be evaluated as an independent variable of HRQOL in future studies.
Researchers need to augment generic HRQOL measures with disease-specific items that may pertain to life areas affected by AS, such as audible valve click, wound healing, and dyspnea. Future research should be inclusive of AS patients who do not undergo surgery. Nurses in a variety of roles can work independently or within a multidisciplinary team to provide interventions for the promotion of HRQOL for patients across all stages of the AS disease process.
虽然心血管疾病患者的健康相关生活质量（HRQOL）研究在不断增加，但很少有研究关注主动脉瓣狭窄（AS）患者的 HRQOL。
对 1997 年至 2008 年间 AS 患者 HRQOL 的研究进行了批判性回顾，以总结研究结果并确定临床和研究意义。
共确定了 28 项研究，均为定量研究，评估了主动脉瓣置换（AVR）后的 HRQOL。未发现护士进行的研究或未接受 AVR 的患者的 HRQOL 测量研究。该文献主要关注年龄和瓣膜类型作为影响术后 HRQOL 的变量。尽管结果各不相同，但老年患者的评分通常与对照组相似或更好。在比较接受生物瓣与机械瓣的患者时，发现 HRQOL 受到瓣膜噪音和抗凝的影响，而不是特定的瓣膜类型。
手术选择不应仅基于年龄。由于术前症状较少的患者在 AVR 后 HRQOL 更好的证据，应在术前尽早考虑症状。抗凝状态应作为未来研究中 HRQOL 的一个独立变量进行评估。
研究人员需要在通用 HRQOL 测量中增加与 AS 相关的特定项目，这些项目可能与受 AS 影响的生活领域有关，例如可闻瓣膜咔哒声、伤口愈合和呼吸困难。未来的研究应包括未接受手术的 AS 患者。各种角色的护士可以独立或在多学科团队中工作，为促进 AS 疾病进程各个阶段患者的 HRQOL 提供干预措施。
