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日本慢性胰腺炎患者行全胰切除联合胰岛自体移植术后的生活质量。

Quality of life after total pancreatectomy with islet autotransplantation for chronic pancreatitis in Japan.

机构信息

Department of Pancreatic Islet Cell Transplantation, National Center for Global Health and Medicine, Tokyo, Japan.

Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application, Kyoto University, Tokyo, Japan.

出版信息

Islets. 2023 Dec 31;15(1):2202092. doi: 10.1080/19382014.2023.2202092.

Abstract

BACKGROUND

Patients with chronic pancreatitis (CP) often have severe and intractable abdominal pain, leading to decreased quality of life (QOL), inability to work or attend school, and increased health care costs due to repeated emergency room visits and hospitalizations.

METHODS

We evaluated the efficacy of total pancreatectomy and islet autotransplantation (TPIAT) in terms of pain control and QOL in CP patients treated at our center in Japan. To evaluate QOL, we used the Short-Form 36 Health Survey version 2 (SF-36v2 Standard, Japanese), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), and Quality of Life Questionnaire-Pancreatic Modification (QLQ-PAN28).

RESULTS

Between August 2016 and June 2019, we performed this procedure in 5 patients. All patients were followed up for 12 months and all transplanted islets were still functioning at the 1-year follow-up. The major adverse events were abdominal wall hemorrhage, intestinal obstruction, intra-abdominal abscess, and abdominal pain requiring hospitalization; no case had sequelae. No major complications were due to islet transplantation. Pain scores improved postoperatively in all patients. Three QOL item dimensions role-physical ( = 0.03125), general health perception ( = 0.03125) and vitality ( = 0.03125) in the SF-36 were significantly improved 12 months after TPIAT. Mean values of many other QOL items improved, though not significantly.

CONCLUSION

The QOL improvement after TPIAT for CP suggests its effectiveness in the Japanese population.

摘要

背景

慢性胰腺炎(CP)患者常伴有严重且难治性腹痛,导致生活质量(QOL)下降、无法工作或上学,并因反复急诊就诊和住院而增加医疗保健费用。

方法

我们评估了全胰切除术和胰岛自体移植(TPIAT)在我们日本中心治疗的 CP 患者的疼痛控制和 QOL 方面的疗效。为了评估 QOL,我们使用了健康调查简表 36 项版本 2(SF-36v2 标准,日本)、欧洲癌症研究与治疗组织生活质量问卷核心 30 项(EORTC QLQ-C30)和胰腺修正生活质量问卷(QLQ-PAN28)。

结果

2016 年 8 月至 2019 年 6 月,我们对 5 名患者进行了该手术。所有患者均随访 12 个月,所有移植的胰岛在 1 年随访时仍在发挥作用。主要不良事件为腹壁出血、肠梗阻、腹腔脓肿和需要住院治疗的腹痛;无病例有后遗症。没有因胰岛移植而导致的重大并发症。所有患者术后疼痛评分均有所改善。SF-36 中的三个 QOL 项目维度躯体角色( = 0.03125)、一般健康感知( = 0.03125)和活力( = 0.03125)在 TPIAT 后 12 个月显著改善。许多其他 QOL 项目的平均值虽然没有显著改善,但也有所提高。

结论

TPIAT 治疗 CP 后的 QOL 改善表明其在日本人群中的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b45/10124982/c57634275d0f/KISL_A_2202092_UF0001_OC.jpg

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