综合治疗重症急性胰腺炎患者的远期疗效及精神健康相关因素分析

Long-term curative effect and emotional health-related factors in combined therapy of severe acute pancreatitis

目的评估综合治疗重症急性胰腺炎（severe acute pancreatitis，SAP）患者的生存质量，分析其精神健康相关影响因素。方法回顾性分析2005年6月至2008年8月出院的综合治疗61例SAP患者相关资料，应用SF-36量表、自评焦虑量表（SAS）及自制健康问卷进行调查，分析其生存质量和精神健康相关影响因素。结果61例SAP中，病例资料完整56例，病死2例，问卷回答不完整5例，无应答4例，有效问卷45例，应答率80．3％。SAP患者的SF-36量表的生理职能、活力、情感职能、精神健康、社会功能、生理功能、健康总体自评和机体疼痛8个维度的得分分别为（66．5±12．3）分、（69．3±13．8）分、（76．8±10．5）分、（69．4±11．0）分、（70．9±10．5）分、（83．7±7．1）分、（82．0±9．5）分和（75．5±12．7）分；与健康对照组相比，总体生存质量相对较好，差异无统计学意义（P〉0．05），但是生理职能、社会功能和精神健康的得分较低，差异有统计学意义（P〈0．05）。导致焦虑倾向的相关精神健康影响因素进行多元逐步回归分析后显示：对疾病的发生和结果的了解程度、出院后并发症情况和回想起住院治疗的经历为影响程度最深的因素（P〈0．05）。结论综合治疗的SAP患者出院后与对照人群相比，总体生存质量较好，但是导致焦虑倾向的相关精神健康影响因素主要有对疾病的了解、出院后的并发症和回想住院的经历等。

Objective To assess the long-term health-related quality of life and emotional health in patients with severe acute pancreatitis （SAP） after combined therapy. Methods The hospital records of 61 patients with SAP treated in our hospital from June 2005 to August 2008 were reviewed. The Rand 36-item Health Survey with accessory question and SAS were mailed to each patient to analyze quality of life and emotional health. Results The means and deviations for each of eight acales （RP, VT, RE, MH, SF, PF, GH, BP） scorea of SF-36 in SAP patients were 66.5±12.3, 69.3±13.8, 76.8±10.5, 69.4±11.0, 70.9±10.5, 83.7±7.1, 82.0±9.5, 75.5±12.7. Compared with general people, SAP patient＇s long-term HRQOL total scores were good except that RP, MH and SF were lower than those of general population （P〈 0. 05）. Multivariate backward regression analysis showed that the cause of suffering, outcome of complication, recall the experience in hospital were the most effectively ones （P〈0.05）. Conclusions The total scores of SAP patient＇s long-term HRQOL after combined therapy are good as compared with general population. The cause of suffering, outcome of complication, recalling the experience in hospital have an effect on anxiety.