捆绑式胰胃吻合术患者术后生活质量调查的初步报告

Preliminary report of quality of life survey in patients after binding pancreaticogastrostomy

目的探讨捆绑式胰胃吻合术(BPG)患者术后生活质量。方法回顾性分析2013年5月至2015年8月在浙江大学医学院附属第二医院行BPG的20例患者临床资料。其中男11例,女9例;年龄23~79岁,中位年龄57岁。17例行胰十二指肠切除术,3例行胰腺中段切除术。患者均签署知情同意书,符合医学伦理学规定。采用汉化的健康调查量表(SF-36)对BPG患者术后健康相关生活质量进行随访调查。将BPG术患者术后6、12个月SF-36健康调查数据分别和健康人群数据进行比较。两组SF-36评分数据比较采用t检验。结果 BPG患者术后6个月时的生理职能、生活功能、情感职能评分分别为(44±43)、(71±22)、(43±42)分,明显低于健康人群的(81±34)、(83±18)、(84±32)分(t=-3.843,-2.480,-4.370;P<0.05)。BPG患者术后12个月时的生理职能、情感职能评分分别为(54±18)、(54±24)分,明显低于健康人群的(81±34)、(84±32)分(t=-2.438,-2.374;P<0.05);而总体健康、生理功能、躯体疼痛、活力、生活功能和精神健康评分与健康人群差异无统计学意义(P>0.05)。结论 BPG患者术后6个月时生理职能、生活功能和情感职能有一定的改变,术后12个月患者生活质量可趋于正常化,但生理职能和情感职能仍有一定影响,应加强心理方面宣教。

Objective To investigate the postoperative quality of life of the patients after binding pancreaticogastrostomy （BPG）. Methods Clinical data of 20 patients who underwent BPG in the Second Affiliated Hospital of Zhejiang University School of Medicine between May 2013 and August 2015 were retrospectively analyzed. Among them, 1t were males and 9 females, aged 23-79 years old with a median age of 57 years old. Seventeen cases underwent pancreaticoduodenectomy and 3 underwent middle segment pancreatectomy. The informed consents of all patients were obtained and the local ethical committee approval was received. Postoperative health-related quality of life of BPG patients was assessed by Chinesized health survey scales （SF-36）. The SF-36 health survey data of the patients at 6 and 12 months after BPG were analyzed and compared with the data of the heathy people using t test. Results The role-physical, social function and role-emotional scores of the patients at 6 months after BPG were respectively 44±43, 71±22 and 43±42, significantly lower than 81±34, 83±18 and 84±32 of the heathy people （t=-3.843, -2.480, -4.370; P〈0.05）. The role-physical and role-emotional scores of the patients at 12 months after BPG were respectively 54±18 and 54±24, significantly lower than 81±34 and 84±32 of the heathy people （t=-2.438, -2.374; P〈0.05）. There were no significant differences in general health, psychological function, body pain, vitality, vital function and mental health scores between the BPG patients and healthy people （P〉0.05）. Conclusions The role- physical, social function and role-emotional of the patients at 6 month after BPG have certain changes. The life quality tends to normalization at 12 month after BPG while the role-physical and role-emotional still have certain effects. Propaganda and education should be strengthened on the psychological aspect.