Stewart J A, Ilkka V H, Jokinen J J, Vakkuri A P, Suojaranta R T, Wennervirta J, Salminen U-S
1 Department of Cardiology, Helsinki University Hospital, Helsinki, Finland.
2 University of Helsinki, Helsinki, Finland.
Scand J Surg. 2018 Dec;107(4):322-328. doi: 10.1177/1457496918766719. Epub 2018 Apr 9.
: Hypothermic circulatory arrest carries a high risk of mortality and neurological complications. An important part of assessing surgical treatment is the evaluation of long-term survival and postoperative health-related quality of life.
: In this prospective study, 30 patients undergoing hypothermic circulatory arrest during surgery of the thoracic aorta, and 31 comparison patients undergoing elective coronary artery surgery without hypothermic circulatory arrest were evaluated for long-term survival and health-related quality of life, using the RAND 36-Item Health Survey questionnaire. The results were compared to national age- and sex-matched reference populations of the chronically ill and healthy adults.
: After 4.6-8.0 years, available study (88%) and comparison (59%) patients were interviewed. The life expectancy was similar with 4- and 8-year survival of 90%, and 87% for the study group, and 94%, and 94% for the comparison group, respectively (log rank test, p = 0.62). The RAND-36 scores for study and comparison groups were congruent in all dimensions, describing physical, mental, and social domains. The study patients' health-related quality of life results were similar to the national reference population with chronic illnesses.
: After hypothermic circulatory arrest, patients undergoing surgery of the thoracic aorta achieve a similar long-term life expectancy and health-related quality of life as do patients undergoing coronary surgery without hypothermic circulatory arrest, and a health-related quality of life similar to the national reference population with chronic illnesses. These results justify operative treatment in this high-risk patient population.
低温循环停搏具有较高的死亡风险和神经并发症风险。评估手术治疗的一个重要部分是对长期生存率和术后健康相关生活质量的评估。
在这项前瞻性研究中，使用兰德36项健康调查问卷，对30例在胸主动脉手术期间接受低温循环停搏的患者以及31例未接受低温循环停搏的择期冠状动脉手术的对照患者进行了长期生存率和健康相关生活质量评估。将结果与按年龄和性别匹配的慢性病和健康成年人的全国参考人群进行比较。
在4.6 - 8.0年之后，对88%的研究对象和59%的对照对象进行了访谈。预期寿命相似，研究组4年和8年生存率分别为90%和87%，对照组分别为94%和94%（对数秩检验，p = 0.62）。研究组和对照组的兰德36项评分在描述身体、心理和社会领域的所有维度上均一致。研究对象的健康相关生活质量结果与患有慢性病的全国参考人群相似。
低温循环停搏后，接受胸主动脉手术的患者与未接受低温循环停搏的冠状动脉手术患者的长期预期寿命和健康相关生活质量相似，且健康相关生活质量与患有慢性病的全国参考人群相似。这些结果证明了对这一高风险患者群体进行手术治疗的合理性。
