Pullens B, Dulfer K, Buysse C M P, Hoeve L J, Timmerman M K, Joosten K F M
Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands.
Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Pediatrics, Intensive Care Unit, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands.
Int J Pediatr Otorhinolaryngol. 2016 May;84:88-93. doi: 10.1016/j.ijporl.2016.02.008. Epub 2016 Mar 4.
The purpose of this study is to evaluate the long-term health related quality of life (HRQoL) in a cohort of children surgically treated for laryngotracheal stenosis (LTS).
Prospective cohort study.
Parents of children between 4 and 18 years at follow-up completed the Child Health Questionnaire Parent Form (CHQ-PF50). Children between 11 and 18 years at follow-up completed the Child Health Questionnaire Child Form (CHQ-CF87). Biographical and pre-operative data were extracted from the hospital records. Post-operative measurements consisted of the Bruce treadmill test and pulmonary function testing (PFT).
Fifty-four parents completed the CHQ-PF50; twenty-one children completed the CHQ-CF87. The CHQ-PF50 was significantly worse than the norm population on the subscales physical functioning, role functioning: emotional/behavior, general health perceptions, family activities, parental impact: emotional, and time. CHQ-CF87 was significantly worse than the norm population on physical functioning and better on mental health. After multivariate analysis, presence of co-morbidities and glottic stenosis are the most important pre-operative factors for worse scores on general health. As post-operative measurements, the Bruce treadmill test and peak expiratory flow (PEF) correlate well with HRQoL physical subscales.
At long-term follow-up after treatment for LTS, deficits in HRQoL may still exist. Presence of co-morbidities and glottic stenosis are important negative factors for long-term HRQoL. The Bruce treadmill test and peak expiratory flow on pulmonary function testing correlate well with physical subscales on HRQoL. A long-term multidisciplinary follow-up with assessment of HRQoL is advised in patients treated for LTS.
2B, individual prospective cohort study.
本研究旨在评估一组接受手术治疗的喉气管狭窄（LTS）患儿的长期健康相关生活质量（HRQoL）。
前瞻性队列研究。
随访时年龄在4至18岁儿童的父母完成儿童健康问卷家长版（CHQ-PF50）。随访时年龄在11至18岁的儿童完成儿童健康问卷儿童版（CHQ-CF87）。从医院记录中提取患儿的个人信息和术前数据。术后测量包括布鲁斯运动平板试验和肺功能测试（PFT）。
54位家长完成了CHQ-PF50；21名儿童完成了CHQ-CF87。CHQ-PF50在身体功能、角色功能：情感/行为、总体健康感知、家庭活动、父母影响：情感以及时间等分量表上显著差于正常人群。CHQ-CF87在身体功能方面显著差于正常人群，而在心理健康方面则较好。多因素分析后，合并症的存在和声门狭窄是总体健康评分较差的最重要术前因素。作为术后测量指标，布鲁斯运动平板试验和呼气峰值流速（PEF）与HRQoL身体分量表相关性良好。
在LTS治疗后的长期随访中，HRQoL可能仍存在缺陷。合并症的存在和声门狭窄是长期HRQoL的重要负面因素。布鲁斯运动平板试验和肺功能测试中的呼气峰值流速与HRQoL的身体分量表相关性良好。建议对接受LTS治疗的患者进行长期多学科随访并评估HRQoL。
2B，个体前瞻性队列研究。
