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对于患有潜在危及生命的心脏离子通道病/心肌病的患者,经视频胸腔镜左心交感神经切除术治疗后的生活质量。

Quality of life after videoscopic left cardiac sympathetic denervation in patients with potentially life-threatening cardiac channelopathies/cardiomyopathies.

作者信息

Antiel Ryan M, Bos J Martijn, Joyce Daniel D, Owen Heidi J, Roskos Penny L, Moir Christopher, Ackerman Michael J

机构信息

Department of General Surgery, Division of Pediatric Surgery.

Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology; Department of Medicine, Division of Cardiovascular Diseases; Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory.

出版信息

Heart Rhythm. 2016 Jan;13(1):62-9. doi: 10.1016/j.hrthm.2015.09.001. Epub 2015 Sep 1.

Abstract

BACKGROUND

Left cardiac sympathetic denervation (LCSD) provides an additive or potentially alternative treatment option for patients with life-threatening cardiac channelopathies/cardiomyopathies.

OBJECTIVE

We sought to examine the effects of LCSD on quality of life (QOL).

METHODS

From November 2005 to May 2013, 109 patients who underwent LCSD were subsequently sent postoperative QOL surveys.

RESULTS

Of 109 patients, 8 (7%) could not be contacted. Of the remaining 101 patients, 62 returned surveys (response rate 61%). There were an average of 4.1 ± 1.8 self-reported side effects immediately after LCSD. The most common anticipated side effects included unilateral hand dryness, color or temperature variance between sides of the face, and abnormal sweating. Although parent-reported pediatric physical QOL scores were lower than national norms, there were no differences in psychosocial QOL or disability scores (P = .09 and .33, respectively). QOL scores for adult patients were not significantly different from a US normative sample. Adult LCSD patients reported less disability than a US normative sample (P < .01). There was no correlation between QOL scores and the presence of anticipated side effects. However, among the subset of pediatric patients who continued to receive ventricular fibrillation-terminating implantable cardioverter-defibrillator shocks after LCSD, there was a correlation between their disability scores and the number of reported shocks (Spearman correlation = 0.56). The majority of patients/parents reported that they were very or somewhat satisfied with their surgery (or their child's surgery) and would definitely or probably recommend LCSD to another patient.

CONCLUSION

Despite the anticipated side effects associated with LCSD, patients are satisfied with their surgery and indicate that they would recommend the surgery to another patient.

摘要

背景

左心交感神经去神经支配术(LCSD)为患有危及生命的心脏离子通道病/心肌病的患者提供了一种辅助性或潜在的替代治疗选择。

目的

我们试图研究LCSD对生活质量(QOL)的影响。

方法

从2005年11月至2013年5月,109例行LCSD的患者随后接受了术后QOL调查。

结果

109例患者中,8例(7%)无法取得联系。其余101例患者中,62例返回了调查问卷(回复率61%)。LCSD后立即出现的自我报告的副作用平均有4.1±1.8种。最常见的预期副作用包括单侧手部干燥、面部两侧颜色或温度差异以及异常出汗。尽管家长报告的儿童身体QOL评分低于全国规范,但心理社会QOL或残疾评分无差异(分别为P = 0.09和0.33)。成年患者的QOL评分与美国标准样本无显著差异。成年LCSD患者报告的残疾程度低于美国标准样本(P < 0.01)。QOL评分与预期副作用的存在之间无相关性。然而,在LCSD后继续接受终止室颤的植入式心脏复律除颤器电击的儿科患者亚组中,他们的残疾评分与报告的电击次数之间存在相关性(斯皮尔曼相关性 = 0.56)。大多数患者/家长报告他们对手术(或其孩子的手术)非常或有些满意,并且肯定或可能会向另一位患者推荐LCSD。

结论

尽管LCSD存在预期的副作用,但患者对手术满意,并表示会向另一位患者推荐该手术。

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