经口内镜下肌切开术治疗贲门失弛缓症后的生活质量：一项系统评价和荟萃分析
Quality of Life Following Peroral Endoscopic Myotomy for Esophageal Achalasia: A Systematic Review and Meta-Analysis.
作者信息
Zhong Chunyu, Tan Shali, Ren Yutang, Lü Muhan, Peng Yan, Fu Xiangsheng, Tang Xiaowei
机构信息
Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Departmemt of Gastroenterology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
出版信息
Ann Thorac Cardiovasc Surg. 2020 Jun 20;26(3):113-124. doi: 10.5761/atcs.ra.19-00273. Epub 2020 Mar 4.
BACKGROUND
Peroral endoscopic myotomy (POEM) is a novel minimally invasive intervention for treating esophageal achalasia. Previous publications have proved its excellent efficacy and safety, and even shown it could improve patients' quality of life (QoL). So, we conducted this study to explore the changes of QoL following POEM.
METHODS
A comprehensive literature search was conducted on PubMed, EMBASE, and Cochrane Library covering the period from January 2009 to April 2019. The statistical analysis was carried out using Review Manager 5.3.
RESULTS
A total of 12 studies including 549 patients were identified, which assessed the QoL using validated questionnaires administered. After POEM, the SF-36 questionnaire score of each domain (physical function, role physical function, body pain, general health (GH), social function, vitality, emotional role function, mental health) was significantly increased (p < 0.05). Meanwhile, mental component scale (MCS) and physical component scale (PCS) scores were all improved in patients after POEM procedure (MCS: 12.11, 95% confidence interval [CI], 4.67-19.55, p = 0.001, I = 88%, PCS: 17.01, 95% CI, 2.91-31.11, p = 0.02, I = 97%). The gastroesophageal reflux disease health-related quality of life questionnaires (GERD-HRQL) also decreased significantly after POEM (13.01, 95% CI, 9.98-16.03, p < 0.00001, I = 30%).
CONCLUSIONS
Our current evidence suggests there is significant improvement in QoL after POEM procedure.
背景
经口内镜下肌切开术（POEM）是一种治疗食管贲门失弛缓症的新型微创干预方法。既往研究已证实其具有卓越的疗效和安全性，甚至表明它可以改善患者的生活质量（QoL）。因此，我们开展本研究以探讨POEM术后生活质量的变化。
方法
在PubMed、EMBASE和Cochrane图书馆进行全面的文献检索，涵盖2009年1月至2019年4月期间。使用Review Manager 5.3进行统计分析。
结果
共纳入12项研究，涉及549例患者，这些研究使用经过验证的问卷评估生活质量。POEM术后，SF-36问卷各领域（身体功能、角色身体功能、身体疼痛、总体健康（GH）、社会功能、活力、情感角色功能、心理健康）的评分均显著提高（p < 0.05）。同时，POEM术后患者的精神健康综合量表（MCS）和生理健康综合量表（PCS）评分均有所改善（MCS：12.11，95%置信区间[CI]，4.67 - 19.55，p = 0.001，I² = 88%；PCS：17.01，95% CI，2.91 - 31.11，p = 0.02，I² = 97%）。经口内镜下肌切开术后，胃食管反流病健康相关生活质量问卷（GERD-HRQL）评分也显著降低（13.01，95% CI，9.98 - 16.03，p < 0.00001，I² = 30%）。
结论
我们目前的证据表明，POEM术后生活质量有显著改善。
Zotero 插件