Sailer M, Bussen D, Debus E S, Fuchs K H, Thiede A
Department of Surgery, University School of Medicine, Würzburg, Germany.
Br J Surg. 1998 Dec;85(12):1716-9. doi: 10.1046/j.1365-2168.1998.00958.x.
Benign proctological conditions are very common in Western civilization. However, to date quality of life in these patients has not been evaluated comprehensively. The aim of this study was to investigate whether the Gastrointestinal Quality of Life Index (GIQLI) is a useful instrument for measuring quality of life in these patients, and subsequently to establish baseline values for different anorectal disorders.
The questionnaire was completed by 325 consecutive patients (182 men; mean age 49 years) seen at the proctology outpatient clinic. For further analysis patients were classified into nine subgroups according to the primary diagnosis: group 1, haemorrhoids (n=96); group 2, anal fissure (n=38); group 3, fistula in ano (n=22); group 4, severe constipation (n=14); group 5, faecal incontinence (n=35); group 6, symptomatic anterior rectocele (n=12); group 7, perianal abscess (n=7); group 8, perianal thrombosis (n=7); and group 9, miscellaneous conditions (e.g. skin tags, anal papillomas, mild constipation, rectal polyps) (n=94). The GIQLI scores were compared between the subgroups. In addition the GIQLI scores of age-matched healthy controls, derived from data in the literature, were compared with the patients' scores.
The mean GIQLI score for all patients was 113 (78.5 per cent of the maximum score of 144). Mean scores for the nine diagnostic subgroups were: group 1, 120; group 2, 104; group 3, 119; group 4, 94; group 5, 93; group 6, 112; group 7, 115; group 8, 129; and group 9, 117. Age-matched controls from a series published previously had a significantly higher GIQLI score compared with all patients (P < 0.0001). However, only the subgroups of patients with miscellaneous conditions, fissures, severe constipation and faecal incontinence had a significantly poorer quality of life than age-matched healthy individuals.
The GIQLI is a valuable instrument for measuring quality of life in patients with benign anorectal disorders. Although certain diseases do not seem to affect quality of life profoundly, certain subgroups of patients, most notably those with incontinence and severe constipation, are extremely compromised. Severely constipated individuals exhibit the same poor quality of life as patients with faecal incontinence.
良性直肠疾病在西方文明中非常常见。然而，迄今为止，这些患者的生活质量尚未得到全面评估。本研究的目的是调查胃肠道生活质量指数（GIQLI）是否是衡量这些患者生活质量的有用工具，并随后确定不同肛肠疾病的基线值。
325例连续就诊于直肠门诊的患者（182例男性；平均年龄49岁）完成了问卷。为进一步分析，根据初步诊断将患者分为九个亚组：第1组，痔疮（n = 96）；第2组，肛裂（n = 38）；第3组，肛瘘（n = 22）；第4组，严重便秘（n = 14）；第5组，大便失禁（n = 35）；第6组，有症状的直肠前突（n = 12）；第7组，肛周脓肿（n = 7）；第8组，肛周血栓形成（n = 7）；第9组，其他情况（如皮赘、肛乳头瘤、轻度便秘、直肠息肉）（n = 94）。比较各亚组的GIQLI评分。此外，将文献中年龄匹配的健康对照的GIQLI评分与患者的评分进行比较。
所有患者的平均GIQLI评分为113分（最高分为144分，占78.5%）。九个诊断亚组的平均评分分别为：第1组，120分；第2组，104分；第3组，119分；第4组，94分；第5组，93分；第6组，112分；第7组，115分；第8组，129分；第9组，117分。与所有患者相比，先前发表的系列研究中年龄匹配的对照组的GIQLI评分显著更高（P < 0.0001）。然而，只有患有其他情况、肛裂、严重便秘和大便失禁的患者亚组的生活质量明显低于年龄匹配的健康个体。
GIQLI是衡量良性肛肠疾病患者生活质量的有价值工具。虽然某些疾病似乎对生活质量影响不大，但某些患者亚组，最明显的是那些有大便失禁和严重便秘的患者，生活质量受到极大影响。严重便秘患者的生活质量与大便失禁患者相同。
