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西班牙肝移植患者的生活质量

Quality of life in spanish patients with liver transplant.

作者信息

Pérez-San-Gregorio M A, Martín-Rodríguez A, Pérez-Bernal J, Maldonado M D

机构信息

Department of Personality, Evaluation and Treatment Psychological, University of Seville, Spain.

出版信息

Clin Pract Epidemiol Ment Health. 2010 Aug 27;6:79-85. doi: 10.2174/1745017901006010079.

Abstract

BACKGROUND

Liver transplantation is the optimal method of treatment in patients with end-stage liver failure. Transplantation medicine has significantly progressed in the last time, but some psychology and psychosomatic problems still remain unsolved. Health-Related Quality of Life (HRQL) in liver transplant is considered a useful measure of evolutionary process of the illness.

OBJECTIVE

The authors analyzed the evolution of HRQL in pre-transplant (waiting-list patients) and post-transplant (first year after liver transplant) periods of liver transplant Spanish patients.

METHODS

A prospective and longitudinal study was carried out among patients who received a liver transplant from a deceased donor. They were assessed in four phases: at the time of inclusion on the transplant waiting-list, and 3, 6, and 12 months after receiving the graft. We used a structured interview and SF-36 and Euroqol-5D (EQ-5D) Health Questionnaires.

RESULTS

The greater differences were found between pre-transplant and post-transplant stages with less well-being in the stage before the transplant. No significantly differences were observed when comparing the 3, 6 and 12 months from post-transplant stage.

CONCLUSION

The HQRL of liver patients improved after the transplant, being appreciated a tendency to the stabilization from three months onwards. We suggest that the psychological intervention, in liver patients, should be conducted in waiting-list patients and in the first 3 months post-transplant, periods with a poor mental health (anxiety, depression, and stress by fear to the unknown thing) and a low adhesion to the treatment that can generate a smaller graft and/or patient survival.

摘要

背景

肝移植是终末期肝衰竭患者的最佳治疗方法。移植医学在过去有了显著进展,但一些心理和心身问题仍未解决。肝移植中的健康相关生活质量(HRQL)被认为是疾病进展过程的一项有用指标。

目的

作者分析了西班牙肝移植患者移植前(等待名单上的患者)和移植后(肝移植后的第一年)HRQL的变化情况。

方法

对接受已故供体肝移植的患者进行了一项前瞻性纵向研究。在四个阶段对他们进行评估:列入移植等待名单时,以及接受移植后3个月、6个月和12个月。我们使用了结构化访谈以及SF - 36和欧洲五维健康量表(EQ - 5D)健康问卷。

结果

移植前和移植后阶段差异较大,移植前阶段的幸福感较低。比较移植后3个月、6个月和12个月时未观察到显著差异。

结论

肝移植患者移植后的健康相关生活质量有所改善,从术后三个月起有趋于稳定的趋势。我们建议,对于肝移植患者,心理干预应在等待名单上的患者以及移植后的前3个月进行,这两个时期心理健康状况较差(焦虑、抑郁以及对未知事物的恐惧导致的压力),且对治疗的依从性较低,而这可能会降低移植物和/或患者的存活率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db1a/2995160/91227cc32dca/CPEMH-6-79_F1.jpg

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