溃疡性结肠炎病人术后生活质量及其影响因素研究  

Research on postoperative quality of life and related factors of patients with ulcerative colitis

作　　者：李冰冰[1] 韩洪秋[1] 刘刚[1] 胡芳[1] 孙晓红[1] 

机构地区：[1]天津医科大学总医院普通外科,天津300052

出　　处：《中国实用外科杂志》2014年第5期441-443,共3页Chinese Journal of Practical Surgery

基　　金：天津市卫生局科技基金(2010KZ114)

摘　　要：目的探讨经全结直肠切除回肠贮袋肛管吻合术(IPAA)治疗的溃疡性结肠炎(UC)病人术后生活质量及其影响因素。方法选取2009—2012年于天津医科大学总医院普外科完成全部IPAA的UC病人42例(观察组),分别于术前及术后12个月采用炎性肠病问卷(IBDQ)进行生活质量调查,并观察术后12个月肛门功能恢复情况。同时调查40名健康人(对照组)生活质量情况,进行比较分析。结果 UC病人术前生活质量显著低于对照组(P<0.05),术后生活质量较术前得到明显改善(P<0.05),与对照组相比差异无统计学意义(P>0.05)。UC病人术后12个月便次越多,Kirwan分级越高,IBDQ各维度得分越低,差异均有统计学意义(P<0.05);Bristol大便分类越高,IBDQ各维度得分下降,在肠道和全身症状得分方面差异有统计学意义(P<0.05),而情感和社会功能方面差异无统计学意义(P>0.05)。结论 IPAA手术治疗UC可显著提高病人生活质量,术后远期肛门功能恢复情况直接影响病人生活质量。Objective To investigate the quality of life and influencing factors of ulcerative colitis （UC） patients after ileal pouch-anal anastomosis （IPAA）. Methods Forty-two UC patients（observation group） underwent the procedure of IPAA between 2009 and 2012 in Tianjin Medical University General Hospital were investigated by IBDQ at admission and 12 months post-operation. The quality of life of 40 normal persons （control group） was investigated simultaneously. The statistical analysis was taken in the investigation. Results The quality of life in UC patients was poorer than that in control group significantly （P〈0.05）. Postoperative quality of life was improved than preoperative one （P〈0.05）. There was no statistical significance between UC postoperative patients and normal group （P〉0.05）. The differences were statistically significant at the different groups of stool frequency during the 24-hour period and the night,the Kirwan grading scale in the four dimensions of quality of life（P〈0.05）. The different Bristol stool form scale were statistically different in bowel and systemic symptom （P〈0.05）. The emotional and social dimensions were no significant difference （P〉0.05）. Conclusion The quality of life could be improved by IPAA for UC patients,and influenced by the long-term anal functional recovery.

关 键 词：溃疡性结肠炎 全结直肠切除回肠贮袋肛管吻合术 肛门功能 生活质量 

分 类 号：R6[医药卫生—外科学]