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非体外循环冠状动脉旁路移植术对患者生活质量的影响。

Effect of Off-Pump Coronary Artery Bypass Surgery on Patients' Quality of Life.

作者信息

Afrand Mohammadhosain, Froozan-Nia Seyed Khalil, Dehghani Hamide, Jalalian Mehrdad, Sarebanhassanabadi Mohammadtaghi

机构信息

Medical Scientific Association,Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Department of Cardiac Surgery, Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

出版信息

Cardiol Res. 2014 Feb;5(1):30-37. doi: 10.14740/cr326e. Epub 2014 Feb 27.

Abstract

BACKGROUND

Off-pump coronary artery bypass (OPCAB) surgery is a common technique used to control the incidence of myocardial ischemia and to increase the lifespan of patients with coronary artery disease (CAD). There is still considerable controversy about effect of OPCAB on patients' quality of life. The purpose of this study was to determine the effect of OPCAB on different aspects of the patients' quality of life.

METHODS

A total of 190 patients who underwent elective OPCAB surgery at Afshar Hospital in Yazd, Iran, from October 2012 through April 2013 participated in the study. Nottingham Health Profile (NHP) questionnaire was used in structured interviews before and 3 months after the OPCAB surgery. Independent samples t-test, Mann-Whitney test and analysis of variance were used for statistical analysis.

RESULTS

Quality of life from the aspect of pain (P = 0.014), energy (P = 0.001), emotional reaction (P < 0.001), social isolation (P = 0.002) and physical activity (P = 0.005) were significantly different, but there was no significant difference in sleep between men and women (P = 0.06). Women achieved a better quality of life 3 months after OPCAB surgery (P < 0.001). There was no significant difference in patients' quality of life in terms of their ejection fraction (P = 0.06). There was no significant difference in patients' quality of life in terms of their New York Heart Association (NYHA) functional class score (P = 0.57). Patients' quality of life scores before OPCAB surgery and 3 months after the surgery showed no significant difference after adjusting for history of myocardial infarction (P = 0.82), hyperlipoproteinemia (P = 0.38), cigarette addiction (P = 0.2), hypertension (P = 0.7) and diabetes mellitus (P = 0.15).

CONCLUSION

Most aspects of patients' quality of life were better after OPCAB surgery. The most obvious finding to emerge from this study was that women's quality of life was better than men's after OPCAB surgery. Since CAD is prevalent and OPCAB is one way to treat and manage this disease, patients' quality of life can be improved if they are managed appropriately after OPCAB surgery (especially for men).

摘要

背景

非体外循环冠状动脉搭桥术(OPCAB)是一种用于控制心肌缺血发生率和延长冠心病(CAD)患者寿命的常用技术。关于OPCAB对患者生活质量的影响仍存在相当大的争议。本研究的目的是确定OPCAB对患者生活质量不同方面的影响。

方法

2012年10月至2013年4月在伊朗亚兹德的阿夫沙尔医院接受择期OPCAB手术的190例患者参与了本研究。在OPCAB手术前和术后3个月进行结构化访谈时使用诺丁汉健康量表(NHP)问卷。采用独立样本t检验、曼-惠特尼检验和方差分析进行统计分析。

结果

在疼痛(P = 0.014)、精力(P = 0.001)、情绪反应(P < 0.001)、社交孤立(P = 0.002)和身体活动(P = 0.005)方面的生活质量有显著差异,但男女在睡眠方面无显著差异(P = 0.06)。女性在OPCAB手术后3个月生活质量更好(P < 0.001)。患者的生活质量在射血分数方面无显著差异(P = 0.06)。患者的生活质量在纽约心脏协会(NYHA)功能分级评分方面无显著差异(P = 0.57)。在调整心肌梗死病史(P = 0.82)、高脂蛋白血症(P = 0.38)、吸烟成瘾(P = 0.2)、高血压(P = 0.7)和糖尿病(P = 0.15)后,OPCAB手术前和术后3个月患者的生活质量评分无显著差异。

结论

OPCAB手术后患者生活质量的大多数方面有所改善。本研究最明显的发现是OPCAB手术后女性的生活质量优于男性。由于CAD很常见且OPCAB是治疗和管理这种疾病的一种方法,如果在OPCAB手术后对患者进行适当管理(尤其是男性),患者的生活质量可以得到改善。

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