儿童活体肝移植中供者的生命质量和心理健康评估  

Quality of life and psychological outcome of donors in pediatric living donor liver transplantation

作　　者：何康[1] 陈小松[1] 李齐根[1] 徐宁[1] 韩龙志[1] 奚志峰[1] 张建军[1] 夏强[1] 

机构地区：[1]上海交通大学医学院附属仁济医院肝脏外科,200127

出　　处：《中华消化外科杂志》2013年第9期681-687,共7页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金面上项目（81270558）

摘　　要：目的探讨儿童活体肝移植中供者的术后生命质量和心理健康水平。方法回顾性分析2006年10月至2012年12月上海交通大学医学院附属仁济医院收治的45例儿童活体肝移植中供者的临床资料。采用sF-36生命质量调查表和SCL-90症状自评量表，评估45例供者术后生命质量和心理健康情况。术后采用门诊复查方式进行随访，随访时间截止2013年5月。采用t检验或秩和检验分析供者性别、年龄、身高、体质量、体质指数、户口类型、医疗保险类型、供者手术时间、术中出血量和随访时间等因素对供者术后生命质量和心理健康的影响。结果45例供者均施行了肝左外叶切除术，其手术时间为（302±103）min、术中出血量为（187±40）ml，供者术中均未输血。45例供者术后无手术相关并发症和死亡发生，全部康复出院，平均住院时间为（7±2）d。45例供者术后获得随访，中位随访时间为636d（163～2413d）。供者术后行sF一36生命质量调查量表评估：其健康改变、一般健康、生理功能、生理职能、情感职能、社会功能、躯体疼痛、活力和精神健康9个方面得分分别为：（61±25）分、（55±17）分、（89±14）分、（80±26）分、（87±25）分、（66±20）分、（82±18）分、（63±14）分、（63±15）分。SCL-90症状自评量表评估：其躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执和精神病性9个方面中位得分分别为：0．25分（0～1．58分）、0．20分（0～1．60分）、0．11分（0～0．89分）、0．15分（0～1．62分）、0．10分（0～1．00分）、0．17分（0～2．67分）、0分（0～1．00分）、0分（0—1．33分）和0分（0—0．80分）；其中2名供者在敌对症状上得分均为2．67分，怀疑存在敌对症状，其余供者在以上9个方面得分均〈2．5分。进一步分析影响供者术后生命质量和心理健康的因Objective To evaluate the quality of life and psychological outcome of donors in pediatric living donor liver transplantation （LDLT）. Methods The clinical data of 45 pediatric LDLT donors who were admitted to the Renji Hospital of Shanghai Jiaotong University from October 2006 to December 2012 were retro- spectively analyzed. The quality of life and psychological outcome were evaluated using the Study Short Form-36 （SF-36） and the Symptom Checklist-90 （SCL-90） respectively. The donors were followed up at the out-patient department till May 2013. The influence of gender, age, height, body weight, body mass index, types of Hukou and medical insurences, operation time for donors, volume of intraoperative blood loss and time for follow-up on the quality of life and psychological outcome of donors were analyzed using the t test or analysis of variance. Results All the 45 donors received left lateral lobectomy. The operation time and volume of intraoperative blood loss were （302 ＋ 103）minutes and （187 ± 40）ml, respectively, and no one received blood transfusion. No complications and death occurred with the mean duration of hospital stay of （7 ＋ 2 ） days. All the donors were followed up with the mean time of 636 days （range, 163-2413 days）. The scores of change of health, general health perception, physical functioning, physical limitations, emotional limitations, social functioning, pain, vitality and mental health were 61 ＋25, 55 ＋17, 89 ±14, 80 ±26, 87 ＋25, 66 ±20, 82 ±18, 63 ＋ 14, 63 ± 15, respectively. The median scores of somatization, obsessive-compulsive, sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid and psychoneuroticism were 0.25 （0-1.58）, 0.20 （0-1.60）, 0.11 （0-0.89）, 0.15 （0-1.62）, 0.10 （0-1.00）, 0.17 （0-2.67）, 0 （0-1.00）, 0 （0-1.33） and 0 （0-0.80）, respectively. The scores of hostility were 2.67 in 2 donors, and the other patients had scores 〈 2.5 in all the 9 aspects. The general health perception of

关 键 词：肝移植 活体 生命质量 心理健康 供者 

分 类 号：R726.5[医药卫生—儿科]