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从成年综合征性颅缝早闭患者的角度看生活质量

The Quality of Life in Adult Patients With Syndromic Craniosynostosis From Their Perspective.

作者信息

Lloyd Mark S, Venugopal Anuradha, Horton Johan, Rodrigues Desiderio, Nishikawa Hiroshi, White Nicholas, Solanki Guirish, Noons Peter, Evans Martin, Dover Stephen

机构信息

Department of Craniofacial Surgery, Birmingham Children's Hospital, Birmingham, UK.

出版信息

J Craniofac Surg. 2016 Sep;27(6):1510-4. doi: 10.1097/SCS.0000000000002886.

Abstract

INTRODUCTION

Clinical intuition may perceive those adults with syndromic craniosynostosis to have a lower quality of life (QOL) compared with the normative population. Classification of facial difference; standardization of cognitive capacity and selection of an appropriate QOL measurement tool provides a less intuitive and more evidence-based method of assessing QOL in this particular group of patients.

METHODS

Adults with syndromic craniosynostosis treated by the same surgeons underwent Whittaker Classification for facial difference by an independent observer. Neuropsychology screening ensured cognitive ability in patients for independent answering of a World Health Organization QOL postal questionnaire. Data analysis using descriptive and z test statistics allowed comparison to nonsyndromic adult United Kingdom data provided by the World Health Organization.

RESULTS

Forty adult patients met authors' inclusion criteria. Whittaker Classification of facial difference ranged from I (31 patients) to II (8 patients) and III (1 patient). Quality of life showed no correlation to facial difference. Quality of life was better in the physical, psychological, and environmental domains compared with the normative adult UK population. However, no statistical difference was found in the social domain. Female Apert syndrome patients had a worse QOL than males in the social domain.

CONCLUSIONS

The counterintuitive findings show that adult syndromic patients with similar cognitive capacity perceive their quality of life as being above that experienced in a normative UK nonsyndromic population with no correlation to the degree of facial difference.

摘要

引言

临床直觉可能会认为,与正常人群相比,患有综合征性颅缝早闭的成年人生活质量(QOL)较低。对面部差异进行分类;对认知能力进行标准化并选择合适的生活质量测量工具,可为评估这一特定患者群体的生活质量提供一种不那么直观但更基于证据的方法。

方法

由同一组外科医生治疗的患有综合征性颅缝早闭的成年人,由一名独立观察者对其面部差异进行惠特克分类。神经心理学筛查确保患者具备认知能力,能够独立回答世界卫生组织生活质量邮政问卷。使用描述性统计和z检验统计进行数据分析,以便与世界卫生组织提供的非综合征性英国成年人数据进行比较。

结果

40名成年患者符合作者的纳入标准。面部差异的惠特克分类范围从I级(31例患者)到II级(8例患者)和III级(1例患者)。生活质量与面部差异无关。与英国正常成年人群相比,身体、心理和环境领域的生活质量更好。然而,在社会领域未发现统计学差异。在社会领域,女性Apert综合征患者的生活质量比男性差。

结论

这些与直觉相悖的发现表明,具有相似认知能力的成年综合征患者认为他们的生活质量高于英国正常非综合征人群,且与面部差异程度无关。

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