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酒精性肝病肝移植候选者移植前心理社会因素的特征:台湾单中心回顾性研究。

Characteristics of Psychosocial Factors in Liver Transplantation Candidates with Alcoholic Liver Disease before Transplantation: A Retrospective Study in a Single Center in Taiwan.

机构信息

Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.

Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.

出版信息

Int J Environ Res Public Health. 2020 Nov 23;17(22):8696. doi: 10.3390/ijerph17228696.

Abstract

Liver transplantation (LT) is an essential treatment for end-stage alcoholic liver disease (ALD). The patients' psychosocial condition plays a vital role in post-transplantation prognosis. A survey of the candidates' psychosocial wellbeing is necessary before LT. This study aims to investigate the psychosocial characteristics, including the depression degree, family function, alcohol use duration, and alcohol abstinence period, of LT candidates with ALD. In addition, 451 candidates for LT due to ALD were enrolled. They received psychosocial evaluations, including depression scale (Hamilton depression rating scale) and family functioning assessment (adaptability, partnership, growth, affection, resolve (APGAR) index). The test scores were analyzed according to age, alcohol use duration, and alcohol abstinence period. The Hamilton depression rating scale (HAM-D) score and the family APGAR index score differentiated significantly according to the age, alcohol use duration, and abstinence period of the LT candidates. The patients with shorter alcohol use duration tended to have more severe depressive symptoms and poorer family support. The younger patients showed a significantly shorter abstinence period, more severe depression, and poorer family functioning than older patients. The younger ALD patients and patients with shorter alcohol use duration showed an increased severity of depression before transplantation. They need more mental health care over time.

摘要

肝移植(LT)是治疗终末期酒精性肝病(ALD)的重要手段。患者的社会心理状况对移植后的预后起着至关重要的作用。在 LT 前有必要对候选者的社会心理状况进行调查。本研究旨在探讨 LT 候选者的 ALD 的社会心理特征,包括抑郁程度、家庭功能、饮酒持续时间和戒酒时间。此外,共纳入 451 名因 ALD 接受 LT 的候选者。他们接受了社会心理评估,包括抑郁量表(汉密尔顿抑郁评定量表)和家庭功能评估(适应性、合作性、成长性、情感性、解决问题的能力(APGAR)指数)。根据年龄、饮酒持续时间和戒酒时间分析测试结果。汉密尔顿抑郁评定量表(HAM-D)评分和家庭 APGAR 指数评分根据 LT 候选者的年龄、饮酒持续时间和戒酒时间有显著差异。饮酒持续时间较短的患者往往有更严重的抑郁症状和较差的家庭支持。年轻患者的戒酒时间明显较短,抑郁症状更严重,家庭功能更差。年轻的 ALD 患者和饮酒持续时间较短的患者在移植前表现出更严重的抑郁。他们需要更多的心理健康护理。

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