成年患者全腔静脉肺动脉连接术后运动耐量及生活质量研究

Exercise capacity and quality of life after total cavopulmonary connection at adults

目的研究成人全腔静脉肺动脉连接术后生活质量及运动耐量情况并分析影响因素。方法回顾性分析2008年1月至2015年12月行全腔静脉肺动脉连接术的21例成年（年龄≥16岁）患者围手术期临床资料，随访患者运动耐量、N末端脑利钠肽、心脏超声、SF-36生活质量评分量表情况，分析影响因素。结果患者平均峰值摄氧量为（19．9±3．6）ml·kg-1·min-1，百分预测值（52．5±8．9）％；重度运动耐量下降6人，轻中度下降15人；SF-36评分生理健康74．4±23．2，心理健康73．6±22．3；术后间隔时间是重度运动耐量下降危险因素（P=0．022）。结论成年全腔静脉肺动脉连接术后患者活动耐量明显下降；SF-36量表评分良好，患者生理及心理健康状况良好；找出更多能很好预测全腔静脉肺动脉连接术后远期生存率及生活质量指标是以后研究的重点。

Objective The aim of this study was to evaluate the clinical and phychology profile after total cavopulmonary connection procedure and to identify the significant determinants of quality of life. Methods Data from 21 patients underwent total cavopulmonary connection procedure from January 2008 to December 2015 were retrospectively analyzed. Patients under- went echocardiography and cardiopulmonary exercise testing. Used ST-36 questionnaire to perceived health status. The NT-ProBNP levels was test. Results 21 patients aged between 19 to 36 years（ mean 26.6 years） were enrolled. The mean follow-up time was （44.2 ± 29.9 ） months. The mean EF was （ 59.4 ± 6.2 ） % , and the peak oxygen uptake was （ 19.9 ± 3.6 ） ml · kg-1· min-1 , percent predict value was（52.5 ± 8.9）%. SF-36 score was well. Independent risk for impaired exercise capacity was interval time from surgery. Conclusion The exercise capacity of total cavopuhnonary connection patients was impaired. Identify more predict factors of the quality of these patients need further study.