Tu Jianfeng, Zhang Jingzhu, Yang Yue, Xu Qiuran, Ke Lu, Tong Zhihui, Li Weiqin, Li Jieshou
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, P.R. China.
Department of Emergency Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang 310014, P.R. China.
Exp Ther Med. 2020 Nov;20(5):75. doi: 10.3892/etm.2020.9203. Epub 2020 Sep 10.
The present study aimed to determine whether a difference in pancreatic function and quality of life (QoL) is present between patients with infected pancreatitis necrosis (IPN) undergoing open necrosectomy (ON) and minimally invasive drainage (MID). The medical records of patients with IPN discharged from Jinling Hospital were retrospectively analyzed. Pancreatic function and QoL were compared between patients treated with ON and MID. Pancreatic endocrine and exocrine function were assessed using the oral glucose tolerance test and fecal elastase-1 (FE-1) test, respectively. The standard Short Form 36 health questionnaire was used to evaluate the QoL of patients. The analysis included 101 patients who underwent either ON (n=40, 39.6%) or MID (n=61, 60.4%). There were no significant differences in exocrine and endocrine pancreatic function between the two groups evaluated based on FE-1, fasting blood glucose, glycated hemoglobin and 2-h plasma glucose (P<0.05). The scores of the QoL questionnaire were significantly higher in patients treated with MID than in patients treated with ON, including the scores of general health perception (19.39±3.07 vs. 17.37±3.63, P=0.003), vitality (18.93±2.88 vs. 17.57±3.47, P=0.035), social role functioning (8.85±1.43 vs. 8.15±1.98, P=0.042), emotional role functioning (5.33±1.07 vs. 4.82±1.25, P=0.034), mental health (24.21±3.31 vs. 22.57±3.91, P=0.026) and the total QoL score (125.12±13.16 vs. 116.50±16.94, P=0.005). In conclusion, although the initial health of the patient may have influenced the treatment provided, patients with IPN who received MID achieved a better post-treatment QoL than those treated with ON. No significant differences between the two groups were observed regarding the endocrine and exocrine functions of the pancreas.
本研究旨在确定接受开放坏死组织清除术(ON)和微创引流术(MID)的感染性胰腺炎坏死(IPN)患者之间胰腺功能和生活质量(QoL)是否存在差异。对从金陵医院出院的IPN患者的病历进行回顾性分析。比较接受ON和MID治疗的患者的胰腺功能和生活质量。分别使用口服葡萄糖耐量试验和粪便弹性蛋白酶-1(FE-1)试验评估胰腺内分泌和外分泌功能。使用标准的简短健康调查问卷36来评估患者的生活质量。分析纳入了101例接受ON(n = 40,39.6%)或MID(n = 61,60.4%)的患者。基于FE-1、空腹血糖、糖化血红蛋白和2小时血浆葡萄糖评估,两组之间的胰腺外分泌和内分泌功能无显著差异(P < 0.05)。接受MID治疗的患者的生活质量调查问卷得分显著高于接受ON治疗的患者,包括总体健康感知得分(19.39±3.07对17.37±3.63,P = 0.003)、活力得分(18.93±2.88对17.57±3.47,P = 0.035)、社会角色功能得分(8.85±1.43对8.15±1.98,P = 0.042)、情感角色功能得分(5.33±1.07对4.82±1.25,P = 0.034)、心理健康得分(24.21±3.31对22.57±3.91,P = 0.026)和总体生活质量得分(125.12±13.16对116.50±16.94,P = 0.005)。总之,尽管患者的初始健康状况可能影响了所提供的治疗,但接受MID的IPN患者治疗后的生活质量优于接受ON的患者。两组之间在胰腺的内分泌和外分泌功能方面未观察到显著差异。