肝移植受者症状经历与生存质量的相关性研究

Relationship between symptom experiences and quality of life in liver transplant recipients

目的了解肝移植受者在术后长期生存过程中的生存质量及其症状经历情况,探索症状经历与生存质量的相关性,为临床加强移植术后受者的随访管理,提高受者生存质量提供依据。方法对1999-2008年在四川大学华西医院肝移植中心接受原位肝移植手术的137例移植受者通过问卷方式调查其生存质量及症状经历情况。结果肝移植受者日常承受的症状平均达17种,其中疲倦乏力、失眠、情绪问题、头昏头痛、腹胀、腹泻等是最常见的不适症状,困扰着半数以上的受者。与一般人群相比,移植受者生存质量显著降低(P<0.01)。多元回归分析显示,受者的症状经历、移植术后生存时间、家庭收入、社会支持情况是其生存质量的主要影响因素,其中受者的症状经历对其生存质量的影响尤为突出。结论肝移植受者在术后长期存活过程中承受着复杂的症状经历,关注受者的症状并提供积极有效的干预应是移植术后随访护理的重要内容。

Objective To describe symptom experiences and quality of life（QOL） in liver transplant recipients and explore the relationship between them,in order to provide a scientific basis and new directions for clinical assessment and intervention to improve QOL of them.Methods One hundred and thirty-seven liver transplant recipients who received liver transplantation from 1999 to 2008 were recruited in this study.They were investigated with The SF-36 Health Survey Questionnaire and Modified Transplant Symptom Occurrence and Symptom Distress Scale（MTSOSD）.Results Liver transplant recipients experienced many symptoms（median 17,range 2-30）.The most commen symptoms were：fatigue and drowsy,sleeplessness,mood swings,dizzy and headache,abdominal distension,and diarrhea,which distressed more than half of the recipients.Compared with a reference general population,the liver transplant recipients showed a significantly worse QOL score（P〈0.01）.The result of stepwise multiple regression analysis showed that the total score of symptom experiences,surviving time after transplantation operation,family income and social support score were significant predictors of QOL.Conclusion Liver transplant recipients suffer from complex symptom experiences after transplantation operation.Symptom management is imperative to be embraced in long-term care planning for liver transplant recipients and effective symptom intervention will result in improved QOL.