Wolosker Nelson, Krutman Mariana, Teivelis Marcelo P, Campbell Taiz P D A, Kauffman Paulo, de Campos José Ribas M, Puech-Leão Pedro
Hospital Israelita Albert Einstein, Universidade de São Paulo, São Paulo, Brazil.
Hospital Israelita Albert Einstein, Universidade de São Paulo, São Paulo, Brazil.
Ann Vasc Surg. 2014 May;28(4):970-6. doi: 10.1016/j.avsg.2013.07.032. Epub 2013 Dec 11.
Studies have suggested that quality of life (QOL) evaluation before video-assisted thoracoscopic sympathectomy for patients with hyperhidrosis may serve as a predictive factor for positive postoperative outcomes. Our study aims to analyze if this tendency is also observed in patients treated with oxybutynin for palmar and axillary hyperhidrosis.
Five hundred sixty-five patients who submitted to a protocol treatment with oxybutynin were retrospectively analyzed between January 2007 and January 2012 and were divided into 2 groups according to QOL assessment before treatment. The groups consisted of 176 patients with "poor" and 389 patients with "very poor" QOL evaluation before oxybutynin treatment. Outcomes involving improvements in QOL and clinical progression of hyperhidrosis were evaluated using a validated clinical questionnaire that was specifically designed to assess satisfaction in patients with excessive sweating.
Improvements in hyperhidrosis after oxybutynin were observed in 65.5% of patients with very poor pretreatment QOL scores and in 75% of patients with poor pretreatment QOL scores, and the only adverse event associated with oxybutynin treatment was dry mouth, which was observed with greater intensity in patients with very poor initial QOL evaluation.
Improvements in hyperhidrosis after oxybutynin treatment were similar in both groups, suggesting that QOL before treatment is not a predictive factor for clinical outcomes, contrasting with surgical results that disclose significantly better results in patients with initially poorer QOL analysis.
研究表明,对于多汗症患者,在电视辅助胸腔镜交感神经切除术之前进行生活质量(QOL)评估可能是术后良好预后的预测因素。我们的研究旨在分析在使用奥昔布宁治疗手掌和腋窝多汗症的患者中是否也观察到这种趋势。
对2007年1月至2012年1月间接受奥昔布宁方案治疗的565例患者进行回顾性分析,并根据治疗前的QOL评估将其分为2组。这两组分别包括176例治疗前QOL评估为“差”的患者和389例治疗前QOL评估为“非常差”的患者。使用专门设计的经过验证的临床问卷评估多汗症患者的生活质量改善情况和多汗症的临床进展,该问卷旨在评估多汗症患者的满意度。
奥昔布宁治疗后,治疗前QOL评分非常差的患者中有65.5%的多汗症得到改善,治疗前QOL评分差的患者中有75%的多汗症得到改善,与奥昔布宁治疗相关的唯一不良事件是口干,在初始QOL评估非常差的患者中更为严重。
两组奥昔布宁治疗后多汗症的改善情况相似,这表明治疗前的QOL不是临床结果的预测因素,这与手术结果形成对比,手术结果显示初始QOL分析较差的患者结果明显更好。