Lawrence K, McWhinnie D, Jenkinson C, Coulter A
Department of Public Health and Primary Care, University of Oxford.
Ann R Coll Surg Engl. 1997 Jan;79(1):40-5.
Inguinal hernia repair is one of the most common surgical procedures undertaken in the NHS. Despite this, no previous work has examined quality of life in this patient group. This study examines quality of life preoperatively and at 3 and 6 months postoperatively in 140 patients undergoing inguinal hernia repair in the context of a randomised controlled trial of laparoscopic versus open hernia repair. Surgery was undertaken on a day case basis, and quality of life was assessed using the Short Form 36 (SF36). In the initial phase of the study, 57% of those screened for suitability met the study inclusion criteria and were randomised. No significant differences were found between laparoscopic and open hernia repair in terms of quality of life at 3 and 6 months postoperatively. No difference was found between 3 and 6 month scores, suggesting that patients had already made a good recovery by 3 months. A significant improvement was found between preoperative and postoperative scores, with the greatest change arising on dimensions assessing pain, physical function, and role limitation owing to physical restriction. After standardising for age, sex, and social class, a comparison of the hernia patients to population norms for the SF36 was consistent with improvement from preoperative to postoperative assessment. This study has demonstrated the improvement in quality of life in patients undergoing elective inguinal hernia repair by experienced surgeons on a day case basis. It has also demonstrated the feasibility of assessing quality of life using generic measures in this patient group. Further work in this area is required. Ultimately, the priority given to elective inguinal hernia repair will depend on how the demonstrated benefits compare with those derived from other elective surgical procedures.
腹股沟疝修补术是英国国民医疗服务体系（NHS）中最常见的外科手术之一。尽管如此，此前尚无研究对该患者群体的生活质量进行过考察。本研究在一项腹腔镜与开放式疝修补术的随机对照试验背景下，对140例接受腹股沟疝修补术的患者术前、术后3个月和6个月的生活质量进行了考察。手术在日间手术基础上进行，生活质量采用简短健康调查问卷（SF36）进行评估。在研究的初始阶段，57%经筛选符合条件的人满足研究纳入标准并被随机分组。在术后3个月和6个月的生活质量方面，腹腔镜疝修补术和开放式疝修补术之间未发现显著差异。3个月和6个月的评分之间没有差异，这表明患者在3个月时已经恢复良好。术前和术后评分之间有显著改善，最大的变化出现在评估疼痛、身体功能以及由于身体受限导致的角色限制等维度上。在对年龄、性别和社会阶层进行标准化后，将疝患者与SF36的人群常模进行比较，结果显示从术前到术后评估有改善。本研究证明了经验丰富的外科医生在日间手术基础上为择期腹股沟疝修补术患者实施手术后，其生活质量得到了改善。它还证明了在该患者群体中使用通用测量方法评估生活质量的可行性。该领域还需要进一步开展工作。最终，择期腹股沟疝修补术的优先程度将取决于所显示的益处与其他择期外科手术的益处相比情况如何。
