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胰腺手术后生活质量评估及影响风险因素的确定。

Evaluation of Postoperative Quality of Life After Pancreatic Surgery and Determination of Influencing Risk Factors.

机构信息

From the Department of Surgery, University Medical Center Schleswig-Holstein, Campus Luebeck, Luebeck.

出版信息

Pancreas. 2021 Mar 1;50(3):362-370. doi: 10.1097/MPA.0000000000001780.

Abstract

OBJECTIVES

The postoperative quality of life (QoL) after pancreatic surgery is frequently impaired. The aim of this study was to evaluate the QoL after pancreatic surgery and its influencing risk factors. Furthermore, an age-adjusted comparison with the normal population of Germany was performed.

METHODS

A total of 94 patients were surveyed. The Short Form-36 questionnaire was sent to all patients undergoing pancreatic surgery between 2013 and 2017. All pathologies and types of pancreatic resections were included. Statistical analyses were performed, and an analysis by the Robert Koch-Institute to determine the health-related age-adjusted QoL in Germany served as control group.

RESULTS

Response rate was 29%. Median time of survey was 28 months. As compared with a normative population, QoL after pancreaticoduodenectomy was significantly impaired. Distal pancreatic resection showed no significant differences. Univariate and Lasso analyses showed that the following factors had a negative impact: coronary artery disease, chronic pancreatitis, and open access. Postoperative enzyme supplementation seemed to have a positive impact.

CONCLUSIONS

Pancreatic surgery leads to long-lasting negative effect on QoL. Distal pancreatic resections and laparoscopic access seemed to be the best tolerated. Complications seems to have less impact, whereas maintaining exocrine and endocrine function seems to have a positive effect.

摘要

目的

胰腺手术后患者的生活质量(QoL)经常受损。本研究旨在评估胰腺手术后的 QoL 及其影响因素,并与德国正常人群进行年龄调整比较。

方法

共调查了 94 名患者。2013 年至 2017 年间接受胰腺手术的所有患者均收到了简短形式 36 问卷。包括所有病理和胰腺切除术类型。进行了统计学分析,并以罗伯特·科赫研究所(Robert Koch-Institute)进行的与健康相关的年龄调整 QoL 分析作为对照组。

结果

回复率为 29%。调查的中位时间为 28 个月。与正常人群相比,胰十二指肠切除术患者的 QoL 明显受损。胰尾部切除术无明显差异。单变量和套索分析表明,以下因素具有负面影响:冠状动脉疾病、慢性胰腺炎和开放性手术。术后酶补充似乎有积极影响。

结论

胰腺手术对 QoL 产生持久的负面影响。胰尾部切除术和腹腔镜手术似乎是最能耐受的。并发症的影响似乎较小,而维持外分泌和内分泌功能则有积极影响。

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