首次三维腹腔镜胆囊切除术 RAND-36 项健康调查：一项前瞻性随机研究。

First RAND-36-Item Health Survey in Three-dimensional Laparoscopy Cholecystectomy: A Prospective Randomized Study.

机构信息

Department of Surgery, Kuopio University Hospital (KUH), Kuopio, Finland.

Science Service Center, Kuopio University Hospital (KUH), Finland and University of Eastern Finland (UEF), Kuopio, Finland.

出版信息

In Vivo. 2023 May-Jun;37(3):1192-1197. doi: 10.21873/invivo.13195.

DOI:10.21873/invivo.13195

PMID:37103083

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10188030/

Abstract

BACKGROUND/AIM: National healthcare organizers require feedback from patients to improve medical treatment methods. Three-dimensional laparoscopy cholecystectomy (3D-LC) is a modern technique in surgery. However, there are no studies with patient feedback from validated questionnaires assessing the postoperative treatment results in 3D-LC.

PATIENTS AND METHODS

Initially 200 patients with symptomatic cholelithiasis were randomized into 3D-LC or mini-laparotomy cholecystectomy (MC) groups. RAND-36-Item Health Survey was performed preoperatively and 4 weeks following surgery relating the survey scores between the 3D-LC and MC groups.

RESULTS

Similar postoperative RAND-36 scores were reported for both groups preoperatively and at 4 weeks following surgery, and no significant differences in RAND-36 domains were shown. When the patients in both study groups were combined, Mental Health (p<0.001), Bodily Pain (p=0.01) and General Health (p=0.016) domain scores were significantly higher, indicating a significantly positive change in quality of life 4 weeks postoperatively, while those for the Role-Physical domain were significantly lower, indicating reduced physical activity during the 4 weeks following surgery. In comparison to the Finnish reference RAND-36 scores, scores at 4 weeks were significantly higher for the Mental Health domain (MC group, p<0.001 and 3D-LC group, p=0.001) whilst scores were significantly lower in four other domains: Physical Functioning, Social Functioning, Bodily Pain and Role-Physical.

CONCLUSION

This study shows, for the first time using the RAND-36-Item Health Survey, relatively similar short-term outcomes in patients 4 weeks following cholecystectomy by 3D-LC and MC. Although scores for three RAND-36 domains were significantly higher postoperatively, indicating a significantly positive change in quality of life, a longer follow-up after cholecystectomy is needed for final conclusions to be drawn.

摘要

背景/目的：国家医疗保健机构需要患者的反馈信息来改进医疗方法。三维腹腔镜胆囊切除术（3D-LC）是一种现代手术技术。然而，目前尚无研究采用验证后的调查问卷获得患者反馈，评估 3D-LC 术后的治疗效果。

患者与方法

最初，200 例有症状的胆石症患者被随机分为 3D-LC 组或小切口开腹胆囊切除术（MC）组。术前和术后 4 周进行 RAND-36 项健康调查，比较 3D-LC 组和 MC 组的调查评分。

结果

两组患者术前和术后 4 周的 RAND-36 评分相似，且 RAND-36 各领域评分无显著差异。当将两组研究对象合并后，精神健康（p<0.001）、躯体疼痛（p=0.01）和总体健康（p=0.016）领域的评分显著升高，表明术后 4 周生活质量显著改善，而躯体活动（Role-Physical）领域的评分显著降低，表明术后 4 周内体力活动减少。与芬兰参考 RAND-36 评分相比，术后 4 周精神健康领域的评分显著升高（MC 组，p<0.001；3D-LC 组，p=0.001），而其他 4 个领域的评分均显著降低：生理功能、社会功能、躯体疼痛和躯体活动。