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评估上颌骨切除患者口腔修复对心理状态和生活质量影响的前瞻性临床试点研究:印度经验

Prospective Clinical Pilot Study to Evaluate the Effect of Prosthodontic Rehabilitation on Psychological Status and Quality of Life in Maxillectomy Patients: An Indian Experience.

作者信息

Vijayabharathi P, Koli Dheeraj Kumar, Jain Veena, Deo S V, Thakar Alok, Deb Koushik Sinha, Nanda Aditi

机构信息

Department of Prosthodontics, Centre for Dental Education and Research, AIIMS, New Delhi, India.

Department of Prosthodontics, Centre for Dental Education and Research, AIIMS, Room no: 214, 2nd floor, New Delhi, 110029 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Sep;74(3):287-295. doi: 10.1007/s12070-021-02476-1. Epub 2021 Mar 2.

Abstract

ABSTRACT

The purpose of the study was to assess psychological status (PS) and quality of life (QOL) before surgical resection of maxilla (T0), 2 weeks after resection (T1), 2 weeks after use of intermediate obturator (T2), before (T3) and 12 weeks after use of definitive obturator (T4). 20 participants, planned for resection of maxilla and subsequent prosthodontic rehabilitation were enrolled. Assessment was done using Hospital Anxiety and Depression Scale (HADS) (HADS-A: anxiety and HADS-D: depression) for PS, World Health Organization Quality of Life BREF (WHOQOL-BREF) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire- Head and Neck Module (EORTC QLQ- H&N35) for QOL, and obturator functioning scale (OFS) for obturator functioning. Six cases were dropped out. Highest HADS-A score was observed presurgically (18.7 ± 1.1) and highest HADS-D score at T1 (18.5 ± 1.8). After rehabilitation, HADS-A and HADS-D decreased significantly ( < 001). Least WHOQOL-BREF score was observed at T1, followed by a consistent, significant rise after rehabilitation at all time intervals ( < 001). Highest EORTC QLQ-H&N 35 score was observed at T1, with significant reduction ( < 0.001) after rehabilitation for all questions, except those related to sexual wellness ( = 1). Highest OFS were observed at T2 (3.1 ± 10.3) and least at T4 (1.9 ± 0.2). QOL and PS decline after maxillectomy. Patient education and rehabilitation with obturator leads to improvement in QOL and PS probably due to restored oral functions, and improved health of soft tissue. Both parameters improved with enhanced obturator quality and time.

REGISTRATION AT CLINICAL TRIALS REGISTRY - INDIA ICMR-NIMS: Reg. No. CTRI/2018/04/013164 http://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1&compid=19&EncHid=67729.89030.

摘要

摘要

本研究旨在评估上颌骨手术切除前(T0)、切除后2周(T1)、使用中间义齿2周后(T2)、使用最终义齿前(T3)以及使用最终义齿12周后(T4)的心理状态(PS)和生活质量(QOL)。招募了20名计划进行上颌骨切除及后续口腔修复的参与者。使用医院焦虑抑郁量表(HADS)(HADS - A:焦虑;HADS - D:抑郁)评估心理状态,使用世界卫生组织生活质量简表(WHOQOL - BREF)和欧洲癌症研究与治疗组织生活质量问卷 - 头颈模块(EORTC QLQ - H&N35)评估生活质量,并使用义齿功能量表(OFS)评估义齿功能。6例退出研究。术前观察到最高的HADS - A评分(18.7±1.1),T1时观察到最高的HADS - D评分(18.5±1.8)。康复后,HADS - A和HADS - D显著降低(P<0.001)。T1时观察到最低的WHOQOL - BREF评分,随后在所有时间间隔康复后持续显著升高(P<0.001)。T1时观察到最高的EORTC QLQ - H&N 35评分,康复后除与性健康相关的问题外(P = 0.1),所有问题均显著降低(P<0.001)。T2时观察到最高的OFS评分(3.1±10.3),T4时最低(1.9±0.2)。上颌骨切除术后生活质量和心理状态下降。患者教育和义齿康复可改善生活质量和心理状态,可能是由于口腔功能恢复以及软组织健康改善。随着义齿质量提高和时间推移,两个参数均得到改善。

在印度临床试验注册中心 - ICMR - NIMS注册:注册号CTRI/2018/04/013164 http://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1&compid=19&EncHid=

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J Indian Prosthodont Soc. 2019 Jan-Mar;19(1):74-78. doi: 10.4103/jips.jips_181_18.

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