重症急性胰腺炎远期疗效及健康相关生命质量分析

Long-term outcome and health-related quality of life in survivors of severe acute pancreatitis

目的评估重症急性胰腺炎(severe acute pancreatitis,SAP)患者的远期疗效及健康相关生命质量,分析其影响因素。方法回顾性分析2003年1月至12月出院的98例 SAP 患者相关病历资料,应用 SF-36量表及自制问卷表进行自评式调查,观察其健康相关生命质量及远期疗效。并与普通人群健康相关生命质量进行比较,作相关影响因素的单因素方差分析。自制问卷表单独分析。结果 98例 SAP 患者中,病历资料完整59例,死亡2例,不能完成量表1例,无应答6例,收回有效问卷50例,应答率89.8%。SF-36量表生理功能、生理职能、情感职能、身体疼痛、活力、精神健康、社会功能和总体健康8个维度的得分分别为:(83±15)分、(62±42)分、(69±36)分、(80±15)分、(69±19)分、(72±15)分、(75±18)分和(65±18)分。与普通人群比较,生理职能和社会功能两项与普通人群间差异有统计学意义(P<0.05)。其余6项与普通人群差异无统计学意义(P>0.05)。影响生理健康总分的变量有治疗方式、住院时间、住院费用造成的经济负担。影响心理健康总分的变量有性别和住院费用造成的经济负担。结论 SAP 患者的健康相关生命质量与普通人群相近,远期疗效及生命质量良好,其影响因素主要有性别、治疗方法、住院时间及经济状况。

Objective To evaluate the health-related quality of life and postdischarge long-term outcome after severe acute pancreatitis. Methods The hospital records of patients with SAP discharged healthily from January 2003 to December 2003 were reviewed. The Rand 36-item Health Survey with accessory question was mailed to each patient. The means and deviations for each of eight scales scores of SF- 36 were calculated, the study population scores were compared with general Chinese population; Univariate analysis was applied to determining the effects of variables such as age, sex, causes of disease, mode of treatment, frequency of surgery ,financial burden, length of stay, chronic complications. Accessory questions were analyzed separately. Results The means and deviations for each of eight scales（ PF, RP, RE, BP, VT, MH,SF,GH） scores of SF-36 in SAP patients were 83 ± 15,62±42,69 ±36,80 ± 15,69 ± 19,72 ± 15,75 ± 18,65 ± 18,compared with general people. Except RP and SF, the others were similar. In the ANOVA of Physical Component Summary, the three variables mode of treatment, financial burden and length of stay were included （ P 〈 0. 05 ） , while in that of Mental Component Summary, the two variables of gender and financial burden were included （ P 〈 0. 05 ） o Conclusions The health-related quality of life in SAP patients is similar to that of general people. Greater attention should he given to mode of treatment, length of stay and financial burden to improve quality of life.