微创与传统手术对先天性心脏病患儿生活质量的影响：一项回顾性倾向评分匹配研究。

Effects of minimally invasive and traditional surgeries on the quality of life of children with congenital heart disease: a retrospective propensity score-matched study.

机构信息

Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.

Department of Cardiovascular Surgery and Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital Central South University, 139 Middle Renmin Road, Changsha, 410011, China.

出版信息

BMC Pediatr. 2021 Nov 24;21(1):522. doi: 10.1186/s12887-021-02978-5.

DOI:10.1186/s12887-021-02978-5

PMID:34819045

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8611858/

Abstract

BACKGROUND

The focus of clinical care after treating congenital heart disease (CHD) has shifted from saving patients' lives to improving their quality of life. This study aimed to examine the influence of minimally invasive and traditional surgeries on the quality of life of children with CHD.

METHODS

This was a retrospective cross-sectional study. A total of 459 children aged 2-18 years with CHD treated at Second Xiangya Hospital of Central South University from July 2016 to June 2017 were enrolled, among whom 219 underwent minimally invasive surgery and 240 traditional surgery. The quality of life of children with CHD after surgery was reported by the patients' parents. We applied propensity score matching to correct for confounding factors and conducted multiple linear regression analysis to examine the related effects of minimally invasive and traditional surgeries on the quality of life of children with CHD.

RESULTS

The scores of problems related to perceived physical appearance in children undergoing minimally invasive surgery was higher than those in those undergoing traditional surgery (p = 0.004). Different treatment modes were independent influencing factors for problems related to perceived physical appearance in children with CHD. There was no significant difference in average treatment effect scores of children undergoing different surgical procedures in other quality of life dimensions (problems related to cardiac symptoms and their treatment, drug treatment, anxiety regarding treatment, cognitive psychology, and communication), suggesting that different operation modes were not independent influencing factors for these related problems.

CONCLUSION

Compared with traditional surgery, minimally invasive surgery can significantly improve the physical appearance perception scores of children with CHD after surgery. Therefore, minimally invasive surgery can improve the quality of life of children with CHD.

摘要

背景

先天性心脏病（CHD）治疗后临床护理的重点已从挽救患者生命转移到提高生活质量。本研究旨在探讨微创和传统手术对 CHD 患儿生活质量的影响。

方法

这是一项回顾性的横断面研究。共纳入 2016 年 7 月至 2017 年 6 月在中南大学湘雅二医院接受治疗的 459 例 2-18 岁 CHD 患儿，其中微创组 219 例，传统手术组 240 例。患儿父母报告了手术后 CHD 患儿的生活质量。我们采用倾向评分匹配法校正混杂因素，并进行多元线性回归分析，以探讨微创和传统手术对 CHD 患儿生活质量的相关影响。

结果

微创组患儿在感知身体外观相关问题上的评分高于传统手术组（p=0.004）。不同的治疗方式是 CHD 患儿感知身体外观相关问题的独立影响因素。不同手术方式在患儿生活质量的其他维度（与心脏症状及其治疗相关的问题、药物治疗、对治疗的焦虑、认知心理和沟通）上的平均治疗效果评分没有显著差异，提示不同的手术方式不是这些相关问题的独立影响因素。