Myken P, Larsson P, Larsson S, Berggren H, Caidahl K
Department of Thoracic and Cardiovascular Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.
J Heart Valve Dis. 1995 Jul;4(4):339-45.
The goal of this study was to determine if there was a difference in the quality of life (QoL) between patients receiving bioprosthetic (Biocor, BIO) or mechanical (St. Jude Medical, SJM) valve prosthesis. In January 1993 we assessed the psychological outcome of heart valve surgery among 183 (87 BIO, 96 SJM) of 220 survivors in a selected and matched cohort of 140 BIO and 140 SJM recipients who had their valve replacement between 1983 and 1989. The BIO and SJM groups were equal in terms of mean age, gender, valve position, educational level, marital status and follow up time. Questions concerning QoL, in terms of coping capacity, social support, and general emotional status as well as emotions concerning valve-related complications, were answered by the patients marking a non-graded visual analogous scale, ranging from total agreement to total disagreement. We found no significant difference between patients receiving BIO and those receiving SJM prostheses regarding coping capacity (62 +/- 2 vs. 65 +/- 2), social support (77 +/- 3 vs. 76 +/- 2), or emotional status (63 +/- 3 vs. 65 +/- 3). When subdividing patients by age below and above 60 years, gender, functional class, valve position and complication, we found several significant differences, but the two prosthetic groups were largely similar. Females had a significantly lower level of coping capacity and emotional status than males. Coping capacity and emotional status were significantly correlated with functional class, while social support was not. Coping capacity tended to be lower among patients who had experienced complications and this was more pronounced with BIO.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是确定接受生物假体(Biocor,BIO)或机械瓣膜(圣犹达医疗公司,SJM)置换术的患者在生活质量(QoL)方面是否存在差异。1993年1月,我们在一个选定且匹配的队列中,对1983年至1989年间接受瓣膜置换术的140名BIO和140名SJM受者中的220名幸存者中的183名(87名BIO,96名SJM)进行了心脏瓣膜手术的心理结果评估。BIO组和SJM组在平均年龄、性别、瓣膜位置、教育水平、婚姻状况和随访时间方面相当。关于QoL的问题,涉及应对能力、社会支持、一般情绪状态以及与瓣膜相关并发症的情绪,由患者在一个无分级的视觉模拟量表上进行标记回答,范围从完全同意到完全不同意。我们发现,接受BIO瓣膜和接受SJM瓣膜置换术的患者在应对能力(62±2对65±2)、社会支持(77±3对76±2)或情绪状态(63±3对65±3)方面没有显著差异。当按年龄60岁以下和以上、性别、功能分级、瓣膜位置和并发症对患者进行细分时,我们发现了一些显著差异,但两个假体组在很大程度上是相似的。女性的应对能力和情绪状态水平明显低于男性。应对能力和情绪状态与功能分级显著相关,而社会支持则不然。经历过并发症的患者应对能力往往较低,在BIO组中这种情况更为明显。(摘要截取自250字)