Reitsma Michelle L, Vandenkerkhof Elizabeth G, Johnston Shawna L, Hopman Wilma M
Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston ON.
J Obstet Gynaecol Can. 2011 Dec;33(12):1241-7. doi: 10.1016/s1701-2163(16)35109-x.
To measure the change in health-related quality of life (HRQOL) before and after gynaecologic surgery and to compare HRQOL to age-matched Canadian normative data.
This prospective observational cohort study consisted of a convenience sample of 460 women scheduled for elective gynaecologic surgery. Women underwent surgery for a variety of reasons, including cancer, menorrhagia/dysfunctional uterine bleeding, benign uterine masses, prolapse or urinary incontinence, and chronic pelvic pain syndromes. Women were recruited preoperatively and followed for six months after surgery. HRQOL questionnaires were completed preoperatively and at six weeks and six months postoperatively, using the SF-36, and compared between time points and against normative data. Analysis included univariate statistics, repeated measures ANOVA, paired t tests, and independent samples t tests.
The mean age of women in the study cohort was 49 years (± 11); the majority were married, employed, had an education beyond high school, were overweight or obese, had a hysterectomy, and had an abdominal incision. Twenty-eight percent underwent surgery for cancer. General and mental health domains showed significant improvement between the preoperative and six-week postoperative assessments, while the remaining domains showed statistically significant declines. All but one (general health) of 10 outcomes saw significant improvements from the preoperative to the six-month follow-up assessment. Preoperatively, the surgical sample scored worse on all but one (role emotional) outcome than the normative data. By six months, domain scores were much closer to normative values.
Health-related quality of life improved considerably from the preoperative period to six months postoperative in women who underwent gynaecologic surgery. When compared with normative data from age-matched women, the surgical sample reported significantly reduced HRQOL preoperatively and at six weeks following surgery, but by six months after surgery HRQOL had rebounded to the point of being comparable to age-matched peers.
测量妇科手术前后健康相关生活质量（HRQOL）的变化，并将HRQOL与年龄匹配的加拿大正常数据进行比较。
这项前瞻性观察队列研究包括一个便利样本，共460名计划接受择期妇科手术的女性。女性因各种原因接受手术，包括癌症、月经过多/功能失调性子宫出血、良性子宫肿块、脱垂或尿失禁以及慢性盆腔疼痛综合征。女性在术前被招募，并在术后随访六个月。使用SF-36在术前、术后六周和六个月完成HRQOL问卷，并在不同时间点之间以及与正常数据进行比较。分析包括单变量统计、重复测量方差分析、配对t检验和独立样本t检验。
研究队列中女性的平均年龄为49岁（±11岁）；大多数已婚、有工作、受过高中以上教育、超重或肥胖、接受过子宫切除术且有腹部切口。28%的女性因癌症接受手术。一般健康和心理健康领域在术前和术后六周评估之间显示出显著改善，而其余领域显示出统计学上的显著下降。从术前到六个月随访评估，10项结果中除一项（一般健康）外，其他所有结果均有显著改善。术前，手术样本除一项（角色情感）结果外，在所有结果上的得分均低于正常数据。到六个月时，各领域得分更接近正常数值。
接受妇科手术的女性从术前到术后六个月，健康相关生活质量有显著改善。与年龄匹配女性的正常数据相比，手术样本在术前和术后六周报告的HRQOL显著降低，但术后六个月HRQOL已反弹至与年龄匹配的同龄人相当的水平。
