食管闭锁手术修复后儿童的健康相关生活质量:一项中国的横断面研究
Health-related quality of life in children after surgical repair of esophageal atresia: a cross-sectional study in China.
作者信息
Feng Zhong, Zhu Haitao, He Weijing, Peng Xueni, Gao Runnan, Tian Yuxin, Cao Xuqing, Chen Gong, Dong Kuiran, Zheng Shan, Shen Chun
机构信息
Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, China.
出版信息
Front Pediatr. 2024 Jan 9;11:1332979. doi: 10.3389/fped.2023.1332979. eCollection 2023.
OBJECTIVE
To investigate health-related quality of life (HRQOL) in patients after surgical repair for esophageal atresia (EA) and identify its potential influencing factors.
METHODS
A total of 102 EA children who had previously visited our hospital participated in this cross-sectional study. Basic data and disease data of the patients were collected. The HRQOL was measured with the Pediatric Quality of Life Inventory4.0 (PedsQL4.0) and EA-QOL questionnaire and ranked on a reverse 0-100 scale, with a higher number indicative of a better HRQOL perception. The scores of PedsQL4.0 in children with EA were collected and compared with that of the demographically matched healthy control group. Meanwhile, the condition-specific HRQOL of EA was analyzed by the EA-QOL questionnaire, and the potential clinical factors that influenced the HRQOL were determined by the generalized linear model.
RESULTS
The group of EA and control reached a similar score in the generic PedsQL4.0 (EA group: 86.55 ± 9.69; control group: 89.41 ± 6.54; = 0.670). There was no significant difference between the EA group and the control group in other domains except the school functioning. Condition-specific HRQOL in the 2-7-year-old group had the highest score in social isolation and stress domain and the lowest score in the physical health and treatment domain, with an overall quality of life score of 83.48 ± 10.22. The scores of the 8-17-year-old group were relatively high in social relationships and health and well-being and lowest in the eating domain, with an overall quality of life score of 89.43 ± 8.57. Heart malformation, complicated esophageal surgery history, respiratory symptoms,and digestive symptoms in the past 1 month were the main factors affecting the HRQOL of children aged 2-7 years. Complicated esophageal surgery history, respiratory symptoms, and digestive symptoms in the past 1 month were the main factors affecting the HRQOL of children aged 8-17 years.
CONCLUSIONS
The findings suggest that patients with EA generally had a good HRQOL. However, EA children with postoperative complications and associated symptoms have lower scores in the EA-QOL questionnaire.
目的
探讨食管闭锁(EA)手术修复术后患者的健康相关生活质量(HRQOL),并确定其潜在影响因素。
方法
共有102例曾到我院就诊的EA患儿参与了这项横断面研究。收集患者的基本数据和疾病数据。采用儿童生活质量量表4.0(PedsQL4.0)和EA生活质量问卷对HRQOL进行测量,并按0-100反向评分,分数越高表明对HRQOL的感知越好。收集EA患儿的PedsQL4.0评分,并与人口统计学匹配的健康对照组进行比较。同时,通过EA生活质量问卷分析EA特定情况下的HRQOL,并通过广义线性模型确定影响HRQOL的潜在临床因素。
结果
EA组和对照组在一般PedsQL4.0中的得分相似(EA组:86.55±9.69;对照组:89.41±6.54;P=0.670)。除学校功能外,EA组与对照组在其他领域无显著差异。2-7岁组特定疾病的HRQOL在社会隔离和压力领域得分最高,在身体健康和治疗领域得分最低,总体生活质量评分为83.48±10.22。8-17岁组在社会关系和健康幸福方面得分相对较高,在饮食领域得分最低,总体生活质量评分为89.43±8.57。心脏畸形、复杂食管手术史、呼吸道症状和过去1个月的消化症状是影响2-7岁儿童HRQOL的主要因素。复杂食管手术史、呼吸道症状和过去1个月的消化症状是影响8-17岁儿童HRQOL的主要因素。
结论
研究结果表明,EA患者的HRQOL总体良好。然而,有术后并发症和相关症状的EA患儿在EA生活质量问卷中的得分较低。