Jang Kyung-Sool, Han Young-Min, Jang Dong-Kyu, Park Sang-Kyu, Park Young Sup
Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
J Korean Neurosurg Soc. 2012 Sep;52(3):179-86. doi: 10.3340/jkns.2012.52.3.179. Epub 2012 Sep 30.
Even in the patients with neurologically good outcome after intracranial aneurysm surgery, their perception of health is an important outcome issue. This study aimed to investigate the quality of life (QOL) and its predictors of patients who had a good outcome following anterior circulation aneurysm surgery as using the World Health Organization Quality of Life instrument-Korean version.
We treated 280 patients with 290 intracranial aneurysms for 2 years. This questionnaire was taken and validated by 99 patients whose Glasgow Outcome Scale score was 4 and more and Global deterioration scale 3 and less at 6 months after the operation, and 85 normal persons. Each domain and facet was compared between the two groups, and a subgroup analysis was performed on the QOL values and hospital expenses of the aneurysm patients according to the type of craniotomy, approach, bleeding of the aneurysm and brain injury.
Aneurysm patients showed a lower quality of life compared with control patients in level of independence, psychological, environmental, and spiritual domains. In the environmental domain, there were significant intergroup differences according to the type of craniotomy and the surgical approach used on the patients (p<0.05). The hospital charges were also significantly different according to the type of craniotomy (p<0.05).
Despite good neurological status, patients surgically treated for anterior circulation aneurysm have a low quality of life. The craniotomy size may affect the QOL of patients who underwent an anterior circulation aneurysm surgery and exhibited a good outcome.
即使是颅内动脉瘤手术后神经功能预后良好的患者,其健康认知也是一个重要的预后问题。本研究旨在使用世界卫生组织生活质量量表韩国版,调查前循环动脉瘤手术预后良好患者的生活质量(QOL)及其预测因素。
我们在2年时间里治疗了280例患有290个颅内动脉瘤的患者。该问卷由99例术后6个月格拉斯哥预后量表评分为4分及以上且整体衰退量表评分为3分及以下的患者以及85名正常人填写并验证。比较两组之间的每个领域和方面,并根据开颅类型、手术入路、动脉瘤出血情况和脑损伤情况,对动脉瘤患者的生活质量值和住院费用进行亚组分析。
与对照患者相比,动脉瘤患者在独立程度、心理、环境和精神领域的生活质量较低。在环境领域,根据开颅类型和患者所采用的手术入路,组间存在显著差异(p<0.05)。住院费用也根据开颅类型存在显著差异(p<0.05)。
尽管神经功能状态良好,但接受前循环动脉瘤手术治疗的患者生活质量较低。开颅大小可能会影响前循环动脉瘤手术预后良好患者的生活质量。