内镜下球囊扩张术对贲门失弛缓症患者生活质量的影响  

Effect of pneumatic balloon dilatation on quality of life in achalasia patients

作　　者：周洪[1] 叶博[2] 张海燕 

机构地区：[1]北京电力医院消化内科,北京100073 [2]上海长海医院消化内科 [3]上海长海医院保健科

出　　处：《上海医学》2014年第7期591-594,共4页Shanghai Medical Journal

摘　　要：目的探讨内镜下球囊扩张术对贲门失弛缓症(AC)患者生活质量的影响。方法采用自身前后对照研究,选择北京电力医院2009年1月—2011年1月因AC行内镜下球囊扩张术的75例患者,采用《AC患者症状计分》和汉化版简明健康调查量表(SF-36)分别对患者的症状和生活质量进行评价。术后定期随访症状评分、食管钡餐检查,以及并发症等。随访1年后,采用SF-36量表再次对患者的生活质量进行评价。结果内镜下球囊扩张术前,93.3%(70/75)的患者症状评分≥3分,经内镜下治疗后,38例患者的症状得以完全改善(完全改善组),20例患者的症状得以部分改善(部分改善组),内镜下球囊扩张术的总有效率为77.3%(58/75)。AC组SF-36量表生活质量各维度的评分值均显著低于中国常模组(P值分别<0.01、0.05)。内镜下球囊扩张术后,患者在SF-36量表生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能和精神健康8个维度上的评分值均较术前显著升高(P值均<0.01),完全改善组的SF-36量表生活质量各维度评分值与中国常模组间的差异均无统计学意义(P值均>0.05)。AC患者症状评分与SF-36量表中的生理功能(r=-0.261,P<0.05)、生理职能(r=-0.416,P<0.01)、躯体疼痛(r=-0.526,P<0.01)、总体健康(r=-0.419,P<0.01)、活力(r=-0.517,P<0.01)、社会功能(r=-0.564,P<0.01)、情感职能(r=-0.522,P<0.01)和精神健康(r=-0.511,P<0.01)8个维度上的评分均呈负相关。结论 AC患者的生活质量较健康者显著下降,经内镜下球囊扩张术治疗后,患者的症状得以明显改善,生活质量得以明显提高。Objective To evaluate the effect of pneumatic balloon dilatation on quality of life in achalasia patients. Methods A total of 72 patients diagnosed as achalasia and treated by pneumatic balloon dilatation in our hospital between January 2009 and January 2011 were enrolled in the study. Clinical symptoms and health- related quality of life were investigated by the symptom scoring for achalasia patient and the 36-item short form health survey （SF-36）. Symptoms, barium meal examination, and complications were followed up after the endoscopic procedure. For those patients with over 1-year follow up, their quality of life was evaluated again by SF-36. Results The scores of symptoms were 3 and more in 70 patients （93.3%） before pneumatic balloon dilatation. The symptoms were completely relieved in 38 patients and partially relieved in 20 after dilatation. The total effective rate of treatment was 77.3% （58/75）. The quality of life in patients with achalasia was significantly lower than the Chinese norm （P〈0.05 or 0.01 ）. The scores of SF-36 in physiological function, physical function, pain, general health, vitality, social ability, emotion and mental health were significantly improved after dilatation （all P〈0.01 ）. There was no significant difference in the scores of SF-36 between completely-relieved patients Chinese norm （all P〉0.05）. The symptom scores of achalasia patients were negatively correlated with the scores of SF-36 in physiological function （ r = - 0.261, P〈0.05）, physical function （ r = - 0.416, P〈0.01 ）, pain （ r = -0.526, P〈0.01）, general health （r= - 0.419, P〈0.01）, vitality （r= -0. 517, P〈0.01）, social ability （r=-0.564, P〈0.01）, emotion （r=-0.522, P〈0.01） and mental health （r=-0.511, P〈0.01）.Conclusion The quality of life in patients with achalasia is significantly decreased as compared with healthy people. However, their quality of life and symptoms can be significantly improved after pneumatic balloon dilatation. （Shan

关 键 词：贲门失弛缓症 内镜下球囊扩张术 生活质量 36-item short-form HEALTH survey 

分 类 号：R656.6[医药卫生—外科学]