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术前左心室射血分数不影响冠状动脉搭桥手术后生活质量的改善。

Preoperative left-ventricular ejection fraction does not influence the improvement in quality of life after coronary artery bypass surgery.

作者信息

Sjöland H, Caidahl K, Wiklund I, Albertsson P, Brandrup-Wognsen G, Karlson B W, Herlitz J

机构信息

Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.

出版信息

Thorac Cardiovasc Surg. 1998 Aug;46(4):198-206. doi: 10.1055/s-2007-1010225.

Abstract

Coronary artery bypass grafting (CABG) is an established treatment for angina pectoris which conveys relief of chest pain and improved physical performance. However, increased survival has only been observed in selected subgroups of patients with advanced coronary artery disease, particularly in the presence of depressed left-ventricular ejection fraction (LVEF). It is therefore of interest to study whether the outcome in terms of quality of life (QoL) is also more favorable in candidates with depressed LVEF. All patients who underwent CABG without concomitant valve surgery in western Sweden between 6.1988 and 6.1991 (n = 2121) were sent questionnaires on QoL involving 3 different instruments, the Physical Activity Score, the Nottingham Health Profile, and the Psychological General Well-being Index. They were submitted before surgery and 3 times in the 2 years thereafter. QoL was improved on all postoperative occasions. The degree of improvement was not associated with preoperative LVEF for any of the instruments. The postoperative Physical Activity Score was associated with preoperative LVEF. The other instruments showed no such association with LVEF. The improvement in QoL during 2 years after CABG is not dependent on the LVEF determined prior to operation. Self-estimated physical abilities are postoperatively associated with preoperative LVEF whereas health-related QoL and general well-being are not.

摘要

冠状动脉旁路移植术(CABG)是治疗心绞痛的一种成熟方法,可缓解胸痛并改善身体机能。然而,仅在患有晚期冠状动脉疾病的特定亚组患者中观察到生存率提高,特别是在左心室射血分数(LVEF)降低的情况下。因此,研究LVEF降低的患者在生活质量(QoL)方面的结果是否也更有利是很有意义的。1988年6月至1991年6月期间在瑞典西部接受CABG且未同时进行瓣膜手术的所有患者(n = 2121)均收到了关于QoL的问卷,问卷涉及3种不同的工具,即体力活动评分、诺丁汉健康量表和心理总体幸福感指数。这些问卷在手术前以及术后2年中的3个时间点发放。所有术后时间点的QoL均有所改善。对于任何一种工具,改善程度均与术前LVEF无关。术后体力活动评分与术前LVEF相关。其他工具与LVEF无此关联。CABG术后2年内QoL的改善不取决于术前测定的LVEF。自我评估的身体能力在术后与术前LVEF相关,而与健康相关的QoL和总体幸福感则不然。

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