不同模式心脏起搏器植入患者生活质量评价

Quality of life evaluation with SF-36 Chinese version in patients with different cardiac pacemaker implantation

目的应用健康状况自评量表(SF-36)评价不同模式心脏起搏器植入术后患者的临床治疗效果和生活质量。方法应用SF-36量表,对植入2种不同模式永久心脏起搏器122例患者术前、术后的生活质量进行评价。结果121例患者手术成功,1例死亡。121例患者术后原有基础心脏病症状得到不同程度缓解。植入术治疗前后SF-36量表评分比较,躯体外疼痛项外,各维度评价得分均术后优于术前。单腔起搏器植入术前与术后各维度评分分别为:生理功能(PF):54.1±20.5,66.8±19.4(P<0.01);生理职能(RP):26.4±11.6,68.8±31.6(P<0.01);躯体疼痛(BP):94.3±17.7,96.8±19.7(P<0.01);总体健康(GH):26.5±15.4,50.3±23.5(P<0.01);精力(VT):46.2±10.9,56.7±15.5(P<0.01);社会功能(SF):35.4±11.8,52.9±17.6(P<0.01);情感职能(RE):22.5±14.4,66.1±19.8(P<0.01);精神健康(MH):46.3±9.6,58.3±13.8(P<0.01);健康变化(HT);40.1±12.5,56.7±19.2(P<0.01)。双腔起搏器植入术前与术后各维度评分分别为:生理功能(PE):60.3±14.2,75.4±13.1(P<0.01);生理职能(RP):25.0±11.3,71.9±27.2(P<0.01);躯体疼痛(BP):95.3±17.7,97.8±19.7(P>0.05);总体健康(GH):97.8±19.7,58.1±15.9(P<0.01);精力(VT):48.2±15.7,63.8±13.4(P<0.01);社会功能(SF):38.3±12.7,60.6±15.4(P<0.01);情感职能(RE):17.1±8.3,61.9±30.1(P<0.01);精神健康(MH):48.6±8.3,64.5±11.5(P<0.01);健康变化(HT):42.7±9.1,64.4±16.9(P<0.05),双腔起搏器治疗效果优于单腔起搏器。结论心脏起搏器植入术治疗缓慢型严重心律失常患者,可从生理功能、心理社会功能等方面提高患者生活质量,是一种安全、有效、可靠的治疗方法,根据患者病情选择生理性起搏模式以提高患者术后的生活质量。

Objective To evaluate the quality of life of the patients with different mode of cardiac pacemaker implantation with the SF-36 Chinese version. Methods One hundred and twenty-two cases of patients with different mode of permanent pacing were investigated before and after the operation with the SF-36 Chinese version. Results Successful surgeries on 121 cases were carried out and surgery on one case was unsuccessful. The original cardiac symptoms of 121 patients were improved in different degress after the operation. The scores of SF-36 in 8 aspects of the patients after the operation was higher than that of before the operation （ P 〈 0. 01 or P 〈 0. 05 ） except for body pain dimension. The preoperative and postoperative scores of the patients with single lumen pacemaker were as following：physical functioning ,54. 1 ± 20.5 vs 66.8 ± 19.4（P〈0.01） ;role - physical,26.4 ± 11.6 vs68. 8 ±31.6（P 〈 0.01） ;bodily pain,94. 3 ± 17.7 vs 96.8 ± 19.7（P 〉 0.05 ） ; general health ,26. 5 ± 15.4 vs 50. 3 ± 23.5 （ P 〈 0. 01 ） ; vitality ,46.2 ± 10. 9 vs 56. 7 ± 15.5 （ P 〈 0. 01 ） ; social functioning ,35.4 ± 11.8 vs 52. 9 ± 17. 6 （ P 〈 0. 01 ） ; role emotional, 22.5 ± 14. 4 vs 66. 1 ± 19. 8 （ P 〈 0. 01 ） ; mental health, 46. 3 ± 9. 6 vs 58. 3 ± 13. 8 （P 〈 0. 01 ） ;reported health transition ,40. 1 ± 12.5 vs 56.7 ± 19.2 （P 〈 0. 01 ）. The preoperative and postoperative scores of the patients with dual chamber pacemaker werer physical functioning, 60. 3 ± 14. 2 vs 75.4 ± 13. 1 （ P 〈 0. 01 ） ; role - physical, 25.0 ± 11.3 vs 71.9 ± 27.2 （ P 〈 0. 01 ） ; bodily pain, 95.3 ± 17.7 vs 97. 8 ± 19.7 （ P 〉 0. 05 ） ;general health,97.8 ± 19.7 vs 58. 1 ± 15.9 （P 〈 0. 01 ） ;vitality ,48. 2 ± 15. 7 vs 63. 8 ± 13. 4 （P 〈 0. 01 ） ;social functioning ,38.3 ± 12. 7 vs 60. 6 ± 15.4 （ P 〈 0. 01 ） ;role emotional, 17.1 ± 8. 3 vs 61.9 ± 30. 1 （ P 〈 0. 01 ） ;mental health ,48.6 ± 8.3 vs 64.5 ± 11.5 （ P 〈 0. 01 ） ;reported health transition,42. 7 ± 9. 1 vs 64.4 ± 16. 9 （ P 〈 0. 05 ）, respectively. There were better therapeutic efficacies in patients with dual chamber pacemaker than those with single lumen pacemaker. Conclusion The quality of life of patients with permanent pacemaker is improved in physiologic and psychosocial function after the operation. It is important to select physiological pacing mode according to patient＇ s condition to enhance the quality of life of the patients after the operation.