Weinryb R M, Gustavsson J P, Liljeqvist L, Poppen B, Rössel R J
Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
J Am Coll Surg. 1995 May;180(5):589-95.
For surgeons familiar with pelvic pouch operation, it is disappointing that the patients, although very satisfied to have a pouch instead of an ileostomy, often have difficulty in specifying exactly how their quality of life really has improved. The present study is an attempt to examine this situation.
In 48 patients with ulcerative colitis undergoing pelvic pouch operation, quality of life (QOL) was studied prospectively when the patients had an ileostomy, and at follow-up evaluation at least one year after restitution of anal defecation. The surgeons' evaluation of functional outcome was compared with those of three independent evaluators (the patient, a psychiatrist, and a psychologist). The Psychosocial Adjustment to Illness Scale, the Well-being Profile, the Global Assessment of Function Scale, and surgical evaluation scales were used.
As assessed by surgeons using the surgical evaluation scales, functional outcome correlated significantly with most of the assessments of QOL done by the three independent evaluators (the patient, a psychiatrist, and a psychologist). Quality of life did not improve with increasing time, either with an ileostomy or with a functioning pelvic pouch. On most evaluations, there was no further significant improvement in QOL after restitution of anal defecation.
The findings suggest that QOL is already satisfactory after "cure" of the disease, and restitution of normal defecation does not yield much further improvement.
对于熟悉盆腔袋手术的外科医生而言，令人失望的是，尽管患者对拥有盆腔袋而非回肠造口术非常满意，但他们往往难以确切说明其生活质量究竟是如何得到改善的。本研究旨在探讨这种情况。
对48例接受盆腔袋手术的溃疡性结肠炎患者，在其有回肠造口术时以及恢复肛门排便至少一年后的随访评估中，前瞻性地研究其生活质量（QOL）。将外科医生对功能结果的评估与三位独立评估者（患者、精神科医生和心理学家）的评估进行比较。使用了疾病心理社会适应量表、幸福感量表、功能总体评估量表和手术评估量表。
通过外科医生使用手术评估量表进行评估，功能结果与三位独立评估者（患者、精神科医生和心理学家）对生活质量的大多数评估显著相关。无论是有回肠造口术还是有功能正常的盆腔袋，生活质量都不会随着时间的推移而改善。在大多数评估中，恢复肛门排便后生活质量没有进一步的显著改善。
研究结果表明，疾病“治愈”后生活质量已经令人满意，恢复正常排便并不会带来进一步的显著改善。
