Savin J, Ogden G R
Department of Dental Surgery and Periodontology, Dundee Dental Hospital and School, UK.
Br J Oral Maxillofac Surg. 1997 Aug;35(4):246-53. doi: 10.1016/s0266-4356(97)90042-5.
The issue of quality of life has largely been neglected within oral surgical practice. A questionnaire was designed to assess the effect of third molar surgery on a number of measures of health care outcome within the first postoperative week, that appeared not to have been previously addressed. These included level of physical discomfort, oral and vocal function, patients' perception of their appearance and social interaction. Patients were asked to complete the questionnaire one day following surgery and again 7 days after surgery. For each question they recorded the answer best describing how they felt, on a 4-point scale. Twenty-nine paired returns were received, for which the results for day 1 and day 7 were summated and compared. A two sample t-test revealed a small but significant improvement in the patients' perception of their quality of life over that time period. When a subset of 11 questions relating to physical wellbeing were analysed using the Wilcoxon Signed Rank Test, a significant improvement in only two of the 11 parameters (ability to masticate and perception of appearance) was found. These results show that within the first postoperative week some patients can experience a deterioration in their quality of life, that extends beyond the traditionally recognized side effects and which shows little improvement in the first postoperative week. It has been stated that patients have a right to know if their lifestyles are to be compromised by the effects of their treatment. We suggest that consideration be given to including reference at the preoperative assessment to some of these outcomes.
口腔外科实践中，生活质量问题在很大程度上被忽视了。设计了一份问卷，以评估第三磨牙手术对术后第一周内一些医疗保健结果指标的影响，这些指标似乎以前未曾涉及。这些指标包括身体不适程度、口腔和发声功能、患者对自身外貌的认知以及社交互动。要求患者在手术后一天和手术后7天分别填写问卷。对于每个问题，他们在4分制量表上记录最能描述自己感受的答案。共收到29份配对回复，将第1天和第7天的结果进行汇总并比较。双样本t检验显示，在此时间段内患者对生活质量的认知有小幅但显著的改善。当使用Wilcoxon符号秩检验分析与身体健康相关的11个问题的子集时，在11个参数中仅发现两个参数（咀嚼能力和外貌认知）有显著改善。这些结果表明，在术后第一周内，一些患者的生活质量可能会下降，这种下降超出了传统上公认的副作用，并且在术后第一周几乎没有改善。有人指出，如果患者的生活方式会因治疗效果而受到影响，他们有权了解这一情况。我们建议在术前评估中考虑提及其中一些结果。
