主动脉瓣重度狭窄患者经导管主动脉瓣膜置换术后生活质量及影响因素分析

Analysis of quality of life and influencing factors after transcatheter aortic valve replacement in patients with severe aortic valve stenosis

目的分析重度主动脉瓣狭窄(AS)患者经导管主动脉瓣膜置换术(TAVR)后生活质量及相关影响因素。方法选择2020年1月至2022年1月福建省立医院收治的92例重度AS患者作为研究对象,所有患者均采用TAVR手术治疗。使用中国心血管病人生活质量评定问卷(CQQC)对患者术前和术后的生活质量进行评估,结合患者一般资料调查问卷结果分析不同类型患者术后的生活质量评分,进而使用逐步回归分析总结重度AS患者TAVR术后生活质量的影响因素。结果患者术后3、6、12个月的CQQC评分高于术前,差异有统计学意义(P<0.05);患者术后3、6、12个月的CQQC评分,两两比较,差异有统计学意义(P<0.05)。不同性别、体重指数以及术后有并发症和无并发症患者的CQQC评分比较,差异无统计学意义(P>0.05);不同年龄、婚姻状况、文化程度、术前心功能分级、术前查尔森基础疾病权重指数(WIC)评分患者的CQQC评分比较,差异有统计学意义(P<0.05)。逐步回归分析结果显示,年龄、婚姻状况和术前心功能分级是重度AS患者TAVR术后生活质量的影响因素(P<0.05)。结论重度AS患者TAVR术后生活质量相较术前显著提高,但随术后时间延长患者生活质量亦会随之下降。年龄、婚姻状况及术前心功能分级均是重度AS患者TAVR术后生活质量的影响因素,建议采取积极措施以改善患者术后生活质量。

Objective To analyze the quality of life and related factors after transcatheter aortic valve replacement(TAVR)in patients with severe aortic valve stenosis(AS).Methods A total of 92 severe AS patients admitted to Fujian Provincial Hospital from January 2020 to January 2022 were selected as the study subjects,all patients were treated with TAVR surgery.The quality of life of patients before and after surgery were assessed using the Chinese questionnaire of quality of life in patients with cordiovascular disease(CQQC),based on the survey questionnaire results of general patient information,after surgery quality of life scores of different types of patients were analyzed and stepwise regression analysis was used to summarize the influencing factors of after surgery quality of life in severe AS patients with TAVR.Results The CQQC scores of patients at 3,6,and 12 months after surgery were higher than those before surgery,the differences were statistically significant(P<0.05).The CQQC scores of the patients at 3,6,and 12 months after surgery were compared,pairwise comparison,the differences were statistically significant(P<0.05).There were no statistically significant differences in CQQC scores between patients of different genders,body mass index and after surgery complications and non complications(P>0.05).The CQQC scores of patients with different age,marital status,educational level,before surgery cardiac function grading,and before surgery Chalson's basic disease weighting index(WIC)score were compared,the differences were statistically significant(P<0.05).The results of stepwise regression analysis showed that age,marital status and before surgery cardiac function grading were the influencing factors of after surgery quality of life in severe AS patients with TAVR(P<0.05).Conclusion The quality of life of patients with severe AS after TAVR surgery has significantly improved compared to before surgery,but with the prolongation of after surgery time,the quality of life of patients will also decrease.age,marital status and before surgery cardiac function grading are all factors that affect the quality of life in patients with severe AS after TAVR surgery.It is recommended to take active measures to improve the quality of life of patients after surgery.