Tang Shasha, Ge Xiaolong, Qi Weilin, Liu Wei, Cao Qian, Zhou Wei
Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Gastroenterol Res Pract. 2019 Jan 9;2019:7674946. doi: 10.1155/2019/7674946. eCollection 2019.
Many patients with Crohn's disease (CD) require surgery in their life. Their future outlook is crucial to psychological and mental health after surgery. This study is aimed at assessing CD patient's outlook after experiencing bowel resection and determining factors associated with patient's outlook.
We used an ad hoc questionnaire (modified WHOQOL-BREF) to assess patients' outlook for the future after bowel resection in CD. All patients who experienced bowel resection for CD from 2015 to 2017 were included in this study. Patients were divided into two groups according to the questionnaire. Patients who had a positive outlook were compared with those who had a negative outlook. The patients' view on timing of surgery was also recorded.
Of 114 eligible patients surveyed, 103 (90.4%) responded. 65 (63.1%) reported that the timing of surgery was appropriate, and 26 patients felt it should have been performed earlier, while remaining 12 preferred a later surgery. 61 (59.2%) patients had a positive outlook of their future lives, while 42 patients had a negative outlook. Factors as the financial burden, employment status, patients' view on timing of surgery, and clinical recurrence were associated with patients' outlook. In the multivariate analysis, only clinical recurrence was an independent risk factor for patient's future outlook.
From this survey, it is clear that most patients who underwent an elective bowel resection for CD are satisfied with their timing of surgery. Patients who have clinical recurrence carry a significant negative outlook for their future life. Postoperative management which focuses on preventing clinical recurrence may enhance patients' outlook for the future.
许多克罗恩病（CD）患者一生中需要接受手术。他们对未来的展望对术后的心理和精神健康至关重要。本研究旨在评估CD患者在接受肠道切除术后的展望，并确定与患者展望相关的因素。
我们使用一份特制问卷（改良的世界卫生组织生活质量简表）来评估CD患者肠道切除术后对未来的展望。纳入了2015年至2017年期间所有因CD接受肠道切除的患者。根据问卷将患者分为两组。将展望积极的患者与展望消极的患者进行比较。还记录了患者对手术时机的看法。
在接受调查的114名符合条件的患者中，103名（90.4%）作出了回应。65名（63.1%）报告手术时机合适，26名患者认为手术应更早进行，其余12名则倾向于更晚进行手术。61名（59.2%）患者对未来生活展望积极，42名患者展望消极。经济负担、就业状况、患者对手术时机的看法以及临床复发等因素与患者的展望相关。在多变量分析中，只有临床复发是患者未来展望的独立危险因素。
从本次调查来看，显然大多数因CD接受择期肠道切除的患者对手术时机感到满意。有临床复发的患者对其未来生活有着显著消极的展望。注重预防临床复发的术后管理可能会改善患者对未来的展望。
