Maxwell Damian, Thompson Stephanie, Richmond Bryan, McCagg Jillian, Ubert Adam
Department of Surgery, West Virginia University/Charleston Division, Charleston, West Virginia 25304, USA.
Am Surg. 2012 Jan;78(1):111-8.
This pilot study examined symptom relief and quality of life in pediatric patients who received laparoscopic cholecystectomy surgery at our institution for biliary dyskinesia. We used two validated questionnaires: the Child Health Questionnaire (CHQ-PF28), to assess general well-being, and the Gastrointestinal Quality of Life Index (GIQLI), to measure gastrointestinal-related health. After Institutional Review Board approval, all patients under the age of 18 years who underwent laparoscopic cholecystectomy for biliary dyskinesia between November 2006 and May 2010 received mailed questionnaires. Preoperative and postoperative data were retrospectively collected from respondents and included age, race, symptoms, gallbladder ejection fraction values, pathologic findings, and clinical course. Of 89 patients meeting inclusion criteria, 21 responded. Mean age at surgery was 13.08 years (range, 8 to 17 years). The most common preoperative symptoms consisted of nausea (100%), postprandial pain (90.5%), right upper quadrant pain (81.0%), and vomiting (66.7%). Mean long-term follow-up interval was 18.9 months (range, 7 to 40 months; SD 10.37). Patients with long-term symptom relief reported significantly higher GIQLI scores than those with enduring symptoms. Examination of the results from the CHQ-PF28 revealed significantly lower scores than a general U.S. pediatric sample in both the Physical and Psychosocial Summary Measures (P < 0.05). Children experiencing long-term symptom cessation after laparoscopic cholecystectomy reported higher quality of life than those who had incomplete or only short-term relief. However, regardless of the degree of symptom relief, the degree of quality of life experienced by our study sample of patients with biliary dyskinesia is lower than that of a comparable U.S. pediatric sample.
这项初步研究调查了在我们机构因胆囊运动障碍接受腹腔镜胆囊切除术的儿科患者的症状缓解情况和生活质量。我们使用了两份经过验证的问卷:儿童健康问卷(CHQ-PF28),用于评估总体健康状况;以及胃肠道生活质量指数(GIQLI),用于衡量胃肠道相关健康状况。经机构审查委员会批准,2006年11月至2010年5月间因胆囊运动障碍接受腹腔镜胆囊切除术的所有18岁以下患者均收到了邮寄问卷。术前和术后数据通过回顾性方式从受访者处收集,包括年龄、种族、症状、胆囊射血分数值、病理结果和临床病程。在89名符合纳入标准的患者中,21人做出了回应。手术时的平均年龄为13.08岁(范围为8至17岁)。最常见的术前症状包括恶心(100%)、餐后疼痛(90.5%)、右上腹疼痛(81.0%)和呕吐(66.7%)。平均长期随访间隔为18.9个月(范围为7至40个月;标准差10.37)。长期症状缓解的患者报告的GIQLI得分显著高于症状持续的患者。对CHQ-PF28结果的检查显示,在身体和心理社会综合测量方面,得分均显著低于美国一般儿科样本(P < 0.05)。腹腔镜胆囊切除术后经历长期症状缓解的儿童报告的生活质量高于症状缓解不完全或仅短期缓解的儿童。然而,无论症状缓解程度如何,我们研究中的胆囊运动障碍患者样本所经历的生活质量程度均低于美国类似儿科样本。