开放性腹部手术后腹壁重建后的生活质量。
Quality of life after abdominal wall reconstruction following open abdomen.
作者信息
Zarzaur Ben L, DiCocco Jennifer M, Shahan Charles P, Emmett Katrina, Magnotti Louis J, Croce Martin A, Hathaway Donna K, Fabian Timothy C
机构信息
Department of Surgery and School of Nursing, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.
出版信息
J Trauma. 2011 Feb;70(2):285-91. doi: 10.1097/TA.0b013e31820b5b80.
BACKGROUND
Management of intra-abdominal hypertension with an open abdomen and planned ventral hernia results in decreased mortality. But, delayed abdominal wall reconstruction (DAWR) is necessary. Results after DAWR demonstrate acceptable recurrence, morbidity, and mortality rates. However, little is known about quality of life (QOL) after DAWR. The purpose of this study was to analyze QOL after DAWR.
METHODS
Patients who had DAWR>15 years were identified from operative logs of a trauma center. Patients were contacted, and a QOL assessment was administered in person or via telephone. The QOL assessment contained the Short-Form 36-Item Health Survey 1.0, the Posttraumatic Stress Disorder (PTSD) Checklist-Civilian Version, and the Centers for Epidemiologic Studies Depression Scale.
RESULTS
The QOL assessment was completed by 41 of 152 patients. The indication for open abdomen was injury in 37 (90%) and emergency operation in 4 (10%). Time to follow-up ranged from 9 months to 14.6 years after DAWR. Of 31 patients working before DAWR, 23% had not returned to work secondary to DAWR. Also, 65% screened positive for depression and 23% screened positive for PTSD. Compared with population norms Physical Component Scores were significantly lower for the study population (41.1±13.2, p<0.05).
CONCLUSION
Patients who undergo DAWR have decreased physical functioning and have a high prevalence of PTSD and depression. Consideration should be given to screening for depression and PTSD in this patient population.
背景
采用开放腹腔和计划性腹侧疝治疗腹腔内高压可降低死亡率。但是，延迟腹壁重建（DAWR）是必要的。DAWR后的结果显示复发率、发病率和死亡率均可接受。然而，关于DAWR后的生活质量（QOL）知之甚少。本研究的目的是分析DAWR后的生活质量。
方法
从一家创伤中心的手术记录中识别出DAWR超过15年的患者。与患者取得联系，并亲自或通过电话进行生活质量评估。生活质量评估包括简明健康调查问卷36项1.0版、创伤后应激障碍（PTSD）检查表-平民版以及流行病学研究中心抑郁量表。
结果
152例患者中有41例完成了生活质量评估。开放腹腔的指征为损伤37例（90%），急诊手术4例（10%）。随访时间为DAWR后9个月至14.6年。在DAWR前工作的31例患者中，23%因DAWR未恢复工作。此外，65%的患者抑郁筛查呈阳性，23%的患者PTSD筛查呈阳性。与总体标准相比，研究人群的身体成分得分显著较低（41.1±13.2，p<0.05）。
结论
接受DAWR的患者身体功能下降，PTSD和抑郁症的患病率较高。应对该患者群体进行抑郁和PTSD筛查。
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