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胆囊切除术后患者与普通人群在生活质量和胃肠道症状方面有何差异?

How Do Quality-of-Life and Gastrointestinal Symptoms Differ Between Post-cholecystectomy Patients and the Background Population?

作者信息

Wanjura Viktor, Sandblom Gabriel

机构信息

Department of Surgery, Faculty of Medicine and Health, Örebro University, Södra Grev Rosengatan, 70185, Örebro, Sweden.

Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.

出版信息

World J Surg. 2016 Jan;40(1):81-8. doi: 10.1007/s00268-015-3240-0.

Abstract

BACKGROUND

Previous studies have indicated a correlation between indication for cholecystectomy and long-term gastrointestinal quality-of-life (QoL). The aim of the present study was to compare QoL in a post-cholecystectomy cohort with the background population and with historical controls.

METHODS

A post-cholecystectomy study group (on average 4 years after cholecystectomy) was compared with a control group from the background population using the Gastrointestinal Quality-of-Life Index (GIQLI). EQ-5D scores were compared with expected scores derived from recent historical data.

RESULTS

The post-cholecystectomy study group (N = 451) had better QoL measured by the EQ-5D compared with historical controls (p < 0.001), similar total GIQLI scores as the control group (N = 390), but scored worse on the GIQLI gastrointestinal symptoms subscale score (p < 0.001). The results include an item-by-item breakdown of the GIQLI questionnaire where the scores for diarrhea, bowel urgency, bloating, regurgitation, abdominal pain, flatus, fullness, nausea, uncontrolled stools, belching, heartburn, restricted eating, and bowel frequency were found to be significantly lower (i.e. worse) in the post-cholecystectomy cohort than in the control group. The opposite was true for relationships, endurance, sexual life, physical strength, feeling fit, not being frustrated by illness, and being able to carry out leisure activities, i.e. items related to general performance and well-being.

CONCLUSIONS

In this study, QoL after cholecystectomy was good, but there was an increased prevalence of gastrointestinal symptoms compared to the background population.

摘要

背景

先前的研究表明胆囊切除术的适应证与长期胃肠道生活质量(QoL)之间存在相关性。本研究的目的是比较胆囊切除术后队列人群与背景人群以及历史对照人群的生活质量。

方法

使用胃肠道生活质量指数(GIQLI),将胆囊切除术后研究组(平均在胆囊切除术后4年)与背景人群中的对照组进行比较。将EQ-5D评分与近期历史数据得出的预期评分进行比较。

结果

与历史对照相比,胆囊切除术后研究组(N = 451)通过EQ-5D测量的生活质量更好(p < 0.001),其GIQLI总评分与对照组(N = 390)相似,但在GIQLI胃肠道症状子量表评分上更差(p < 0.001)。结果包括GIQLI问卷的逐项分解,其中发现腹泻、排便急迫感、腹胀、反流、腹痛、肠胃气胀、饱腹感、恶心、大便失禁、嗳气、烧心、饮食受限和排便频率等项目的评分在胆囊切除术后队列中明显低于(即更差)对照组。在人际关系、耐力、性生活、体力、感觉健康、不因疾病而沮丧以及能够进行休闲活动等方面,即与总体表现和幸福感相关的项目,则情况相反。

结论

在本研究中,胆囊切除术后的生活质量良好,但与背景人群相比,胃肠道症状的患病率有所增加。

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