机构地区:[1]河南中医学院第一附属医院周围血管科,河南省郑州市450000
出 处:《中国全科医学》2014年第3期274-277,281,共5页Chinese General Practice
摘 要:目的探讨原发性下肢慢性静脉功能不全(PCVI)患者术后远期生活质量及其影响因素。方法采用分层整群抽样的方式,以手术方式(术式)作为分层标准,抽取2006年1月—2008年1月本科收治的PCVI患者160例,分成4个组:A组为大隐静脉高位结扎剥脱术者,B组为股浅静脉瓣膜环缩加大隐静脉高位结扎剥脱术者,C组为股腘静脉瓣膜环缩加大隐静脉高位结扎剥脱术者,D组为腘静脉瓣膜环缩加大隐静脉高位结扎剥脱术者。采用下肢慢性静脉功能不全生活质量调查问卷(CVIQ)评价并比较4组患者术后远期生活质量(主要包括下肢疼痛、体能活动、社会活动、精神心理4个维度及综合评分)、复发率及并发症发生率;并采用二元Logistic回归法分析患者远期生活质量的相关影响因素。结果 (1)平均随访PCVI患者(69.2±7.2)个月,术后下肢疼痛、体能活动、社会活动(除C组外)、精神心理及综合评分均达到满意标准。4组患者远期生活质量、复发率及并发症发生率比较,差异均无统计学意义(P>0.05)。(2)Logistic回归分析显示,伴发疾病数(除了与下肢疼痛评分无回归关系外)、复发和术后并发症与远期生活质量的4个维度评分及综合评分均存在回归关系(P<0.05);职业与下肢疼痛评分、综合评分,年龄、体质指数(BMI)与体能活动评分及社会活动评分,性别与精神心理评分均存在回归关系(P<0.05)。结论不同术式的PCVI患者远期生活质量间无差异;其远期生活质量与伴发疾病数、病情复发及术后并发症的发生相关,并受职业、年龄、BMI、性别的影响,故进一步降低术后复发及并发症的发生率是提高患者远期生活质量的关键。Objective To discuss the factors influencing postoperative long - term life quality of the patients suffering from primary chronic venous insufficiency (PCVI) . Methods Stratified cluster sampling was used with surgical method as the stratification standard to select 160 PCVI patients admitted to our hospital from January 2006 to January 2008. The patients were divided into four groups: group A was the patients who had ligation and stripping of the great saphenous vein; Group B was the patients who had encircling constriction on the valve of superficial femoral vein plus ligation and stripping of the great saphcnous vein; Group C was the patients who had encircling constriction on the valve of femoropoplitea plus ligation and stripping of the great saphenous vein ; Group D was the patients who had encircling constriction on the valve of popliteal vein plus ligation and stripping of the great saphenous vein. Chronic venous insufficiency questionnaire (CVIQ) was used to assess and compare the life quality of the four groups in terms of lower limb pain, physical, social and mental activities. The recurrence rate and incidence of complication were also compared in the four groups. Binary Logistic regression was used to analyze patients' long - term life quality and influencing factors. Results The PCVI patients were followed up for (69. 2 ± 7. 2) months, and the results showed that the lower limb pain, physical, social ( except group C) and mental activities all achieved satisfactory standard. The long - term life quality, recurrence rate and incidence of complication showed no statistically significant difference in the four groups (P 〉 0. 05). Logistic regression analysis showed that the number of combined diseases ( except no regression relation with lower limb pain score) , recurrence rate and incidence of complication showed regression relationship with the four aspects of life quality (P 〈 0.05 ) . Occupation had relationship with lower limb pain score and comprehensive sco
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