结节性甲状腺肿患者接受甲状腺全切除术后的生活质量调查

Quality of Life in The Patients Received Total Thyroidectomy for Nodular Goiter

目的评估甲状腺全切除术对结节性甲状腺肿患者的健康相关生活质量的影响。方法选择笔者所在医院2009年1月至2011年12月期间行甲状腺全切除术的结节性甲状腺肿患者作为研究对象(甲状腺全切除组),并且选择同期行甲状腺腺叶切除术、年龄相近的结节性甲状腺肿患者作为对照(甲状腺腺叶切除组),采用欧洲五维健康相关生活质量量表(EQ-5D)对2组患者的生活质量进行调查。比较2组患者的生活质量,并将甲状腺全切除组患者的结果与第四次国家卫生服务调查中的普通人群结果进行比较。结果甲状腺全切除组回收有效问卷26份,甲状腺腺叶切除组回收有效问卷28份。2组患者的人口统计学特征基本相似,其行动能力、自我照顾能力、日常活动能力、疼痛/不舒服情况、焦虑/抑郁情况及VAS得分比较差异均无统计学意义(P>0.05)。此外,与普通人群相比,甲状腺全切除组患者"疼痛/不舒服"选项选择中度及以上异常者的比例较高〔30.8%(8/26)比9.2%(16 330/177 501),P<0.01〕;其余方面与普通人群比较差异均无统计学意义(P>0.05)。结论结节性甲状腺肿患者接受甲状腺全切除术对患者生活质量的影响较小。

Objective To evaluate the impact of total thyroidectomy on health-related quality of life （HRQOL） in patients with nodular goiter. Methods The patients who underwent total thyroidectomy from Jan. 2009 to Dec. 2011 in our hospital were retrospectively analyzed with regard to the quality of life （total thyroidectomy group）. The patients with similar demographic features who underwent hemithyroidectomy during the same period were matched as control （hemithyroidectomy group）. The validated HRQOL instrument, which was the Euro quality of life-5D （EQ-5D）, was applied to measure the HRQOL. Comparison of HRQOL in patients of 2 groups was performed, meanwhile, the data of total thyroidectomy group was compared with data of normal population who were obtained from The Forth National Health Survey. Results There were 26 and 28 valid questionnaires returned for the total thyroidectomy group and hemithyroidectomy group respectively. The demographic features of patients in 2 groups were comparable. No significant variance could be found between the 2 groups that there were no significant differences on the mobility, self-care, usual activities, pain/discomfort, anxiety/depression, and visual analogous scales （P〉0. 05）. Furthermore, no significant differences in HRQOL were found in EQ-5D questionnaire compared with normal population derived from The Forth National Health Survey （P〉 0.05）, except that there were more patients complained of moderate and severe pain/discomfort in the total thyroidectomy group [30.8% （8/26） vs. 9.2% （16 330/177 501）, P〈0.01]. Conclusion Total thyroidectomy appears to have little impact on the quality of life in the patients with nodular goiter.