肝血管瘤患者手术治疗后生存质量评价  

Assessment of quality of life after surgery for patients with hepatic hemangioma

作　　者：高维克 戴朝六[1] 许永庆[1] 赵阳[1] 卜献民[1] 苏洋[1] 赵亮[1] 徐锋[1] Gao Weike;Dai Chaoliu;Xu Yongqing;Zhao Yang;Bu Xianmin;Su Yang;Zhao Liang;Xu Feng(Department of Hepatobiliary and Splenic Surgery,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院肝胆脾外科,沈阳110004

出　　处：《中华消化外科杂志》2019年第12期1129-1135,共7页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金资助项目(81701570)。

摘　　要：目的评价肝血管瘤患者手术治疗后生存质量。方法采用回顾性描述性研究方法。收集2011年9月至2017年2月中国医科大学附属盛京医院收治的104例行手术治疗肝血管瘤患者的临床资料;男28例,女76例;年龄为(49±8)岁,年龄范围为27~78岁。根据患者肿瘤位置情况行肝血管瘤剥除术或肝切除术。观察指标:(1)手术及术后情况。(2)患者生存质量评价情况。(3)合并其他消化道慢性疾病患者生存质量情况。正态分布的计量资料以x􀭰±s表示,偏态分布的计量资料以M(范围)表示。重复测量的计量资料采用重复测量方差分析,组间比较采用t检验。计数资料以绝对数表示。结果(1)手术及术后情况:104例患者中,67例行肝血管瘤剥除术,37例行肝切除术。104例患者肿瘤直径为(10±4)cm,术中出血量为200 mL(10~3000 mL),术后住院时间为(11±5)d。7例患者术后发生并发症,其中腹腔大量积液5例、腹腔感染1例、肺梗塞1例,无死亡病例。(2)患者生存质量评价情况:104例肝血管瘤患者术前《消化道相关生存质量指数量表》(GIQLI)总分、主观症状、生理状态、精神心理和社会活动评分分别为(121.0±8.3)分、(69.2±4.1)分、(18.5±2.6)分、(19.5±1.8)分和(13.8±1.4)分。术后1个月,104例肝血管瘤患者上述指标分别为(121.9±6.9)分、(71.2±3.8)分、(17.2±2.5)、(19.6±2.3)分和(13.8±1.3)分。术后6个月,104例肝血管瘤患者上述指标分别为(127.8±6.2)分、(73.2±3.6)分、(19.8±2.5)分、(20.8±2.4)分和(14.1±1.0)分。上述指标比较均有统计学意义(F=68.4,64.6,71.4,17.8,3.3,P<0.05)。术后1个月与术前比较,主观症状、生理状态评分差异均有统计学意义(t=-5.780,6.640,P<0.05),GIQLI总分、精神心理和社会活动评分比较,差异均无统计学意义(t=-1.569,-0.705,0.240,P>0.05)。术后6个月与术前比较,GIQLI总分、主观症状、生理状态、精神心理评分差异均有统计学意义(t=-8.897,-9.9Objective To evaluate the postoperative quality of life after surgery of patients with hepatic hemangioma.Methods The retrospective and descriptive study was conducted.The clinical data of 104 patients who underwent surgery for hepatic hemangioma at Shengjing Hospital of China Medical University from September 2011 to February 2017 were collected.There were 28 males and 76 females,aged(49±8)years,with a range of 27-78 years.Enucleation of hepatic hemangioma or hepatectomy was selected according to tumor location of patients.Observation indicators:(1)surgical and postoperative situations;(2)assessment of quality of life in patients;(3)assessment of quality of life in patients comorbid with other chronic digestive diseases.Measurement data with normal distribution were represented as Mean±SD,and measurement data with skewed distribution were represented as M(range).Repeated data were analyzed using repeated ANOVA.Count data were represented as absolute numbers.Results(1)Surgical and postoperative situations:of 104 patients,67 underwent enucleation of hepatic hemangioma,37 underwent hepatectomy.The tumor diameter,volume of intraoperative blood loss,duration of postoperative hospital stay were(10±4)cm,200 mL(range,10-3000 mL),(11±5)days.Seven patients had complications,including 5 of massive abdominal ascites,1 of abdominal infection,and 1 of pulmanory obstruction.There was no death occurred.(2)Assessment of quality of life in patients with hepatic hemangioma:the total scores of Gastrointestinal⁃related Quality of Life Index(GIQLI),the scores of subjective symptoms,physiological status,mental and psychological status,and social activities were 121.0±8.3,69.2±4.1,18.5±2.6,19.5±1.8,and 13.8±1.4 at preoperation.The above indices were 121.9±6.9,71.2±3.8,17.2±2.5,19.6±2.3,and 13.8±1.3 of 104 patients with hepatic hemangioma at one month after surgery,respectively.The above indices were 127.8±6.2,73.2±3.6,19.8±2.5,20.8±2.4,and 14.1±1.0 at 6 months after surgery.There were significant differences in cha

关 键 词：肝血管瘤 手术 肝血管瘤剥除术 肝切除术 生存质量 

分 类 号：R73[医药卫生—肿瘤]