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溃疡性结肠炎患者结肠切除术的长期预后

Long-term outcomes of colectomy surgery among patients with ulcerative colitis.

作者信息

Brown Carl, Gibson Peter R, Hart Ailsa, Kaplan Gilaad G, Kachroo Sumesh, Ding Qian, Hautamaki Emily, Fan Tao, Black Christopher M, Hu Xiaohan, Beusterien Kathleen

机构信息

Division of General Surgery, Providence Health Care, St. Paul's Hospital, Room C310, St Paul's Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada.

Department of Gastroenterology, The Alfred Hospital and Monash University, Melbourne, VIC 3004 Australia.

出版信息

Springerplus. 2015 Oct 5;4:573. doi: 10.1186/s40064-015-1350-7. eCollection 2015.

Abstract

The objective of this study was to evaluate long-term health-related quality of life outcomes among patients who had a colectomy within the previous 10 years. A cross-sectional survey was administered to consecutive patients ≥18 years of age with ulcerative colitis who had a colectomy within the last 10 years from centers in Canada, Australia, and the United Kingdom. Data were extracted from medical chart reviews to confirm selected self-reported patient characteristics. Of 351 survey respondents, 49 % were male and the median age was 40 years (interquartile range 30-52). Respondents were diagnosed with UC a median of 9.2 (5.7-15.1) years prior to the survey and first surgery occurred a median of 3.7 (2.1-5.8) years ago. Although most respondents (84 %) reported improved quality of life compared to the status before surgery, 81 % experienced problems in at least one of the following areas: depression, work productivity, restrictions in diet, body image, and sexual function. According to HADS scores, 30 and 17 % of survey respondents experienced anxiety and depression, respectively. Among moderate to severe UC patients pre-colectomy, 27 % of men and 28 % of women reported that their sexual life was worse now than before surgery. The mean EQ-5D utility index score overall was 0.79 (95 % confidence interval 0.77-0.81). Quality of life after colectomy for UC is generally good, but there are persistent quality of life issues that impact multiple domains, including psychological and sexual functioning.

摘要

本研究的目的是评估在过去10年内接受结肠切除术的患者与健康相关的长期生活质量结果。对来自加拿大、澳大利亚和英国各中心的年龄≥18岁、在过去10年内接受过结肠切除术的溃疡性结肠炎患者进行了一项横断面调查。从病历回顾中提取数据以确认选定的患者自我报告特征。在351名调查受访者中,49%为男性,中位年龄为40岁(四分位间距为30 - 52岁)。受访者在调查前中位9.2(5.7 - 15.1)年被诊断为溃疡性结肠炎,首次手术发生在中位3.7(2.1 - 5.8)年前。尽管大多数受访者(84%)报告与手术前相比生活质量有所改善,但81%的受访者在以下至少一个方面存在问题:抑郁、工作效率、饮食限制、身体形象和性功能。根据医院焦虑抑郁量表(HADS)评分,分别有30%和17%的调查受访者存在焦虑和抑郁。在结肠切除术前的中重度溃疡性结肠炎患者中,27%的男性和28%的女性报告他们现在的性生活比手术前更差。总体平均EQ - 5D效用指数评分为0.79(95%置信区间0.77 - 0.81)。溃疡性结肠炎患者结肠切除术后的生活质量总体良好,但存在持续影响多个领域的生活质量问题,包括心理和性功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6605/4628015/d9e88d4f37dd/40064_2015_1350_Fig1_HTML.jpg

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