不同量表对人工角膜植入术后患者的生活质量评估研究  

Quality of life of patients after keratoprosthesis implantation assessed by different scales

作　　者：李燕[1] 梅丽娜[1] 李满梅[1] 王丽强[1] LI Yan;MEI Li’na;LI Manmei;WANG Liqiang(Senior Department of Ophthalmology,the Third Medical Center,Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第三医学中心眼科医学部,北京100039

出　　处：《解放军医学院学报》2022年第10期1060-1064,共5页Academic Journal of Chinese PLA Medical School

基　　金：国家自然科学基金项目(81670830)。

摘　　要：背景人工角膜植入手术是终末期角膜盲患者复明的有效手段,术后患者的视觉相关生活质量评估已然成为眼科学者研究的课题。目的比较国家眼科研究所视功能问卷(National Eye Institute Visual Functioning Questionnaire-25,NEI-VFQ-25)、视功能损害眼病患者生存质量量表(Scale of Quality of Life for Diseases with Visual Impairment,SQOL-DVI)、视功能和生活质量(visual function and quality of life,VF-QOL)量表评估人工角膜患者生活质量的效果。方法选择2015年1月-2019年12月于我中心眼科行米赫型人工角膜植入手术患者,采用NEI-VFQ-25、SQOL-DVI、VF-QOL三种量表对患者进行问卷调查,评估术后患者生活质量,并比较不同视力水平患者[以视力(visual acuity,VA)=0.3为切点]的生活质量差异。结果共纳入手术后患者48例,其中男43例(89.58%),女5例(10.42%),年龄21~81(47.08±13.08)岁。NEI-VFQ-25量表总分为50.81±20.86,VF-QOL量表总分为68.37±20.02,SQOL-DVI量表总分为101.38±36.65,VF-QOL量表总分均值占满分的百分比高于NEI-VFQ-25量表和SQOL-DVI量表(68.37%vs 50.81%和50.69%),但均显示米赫型人工角膜植入术后脱盲患者生活质量处于中等水平。不同视力水平患者比较:VA<0.3者各量表得分[Md(IQR)]均低于VA≥0.3者,差异有统计学意义[NEI-VFQ-25:40.00(28.00~50.25)vs 60.50(39.75~76.25),P=0.011;VF-QOL:68.48(56.45~84.64)vs 80.52(63.46~86.53),P=0.020;SQOL-DVI:53.75(38.50~67.00)vs 99.00(70.25~128.75),P<0.001]。各维度评估中,NEI-VFQ-25量表结果显示低视力者(VA<0.3)的整体视力、近距离活动、远距离活动、社会功能、角色限制、驾驶功能等得分更低(P<0.05),在评估视力状况对患者心理健康方面的影响时缺乏敏感性(P>0.05);VF-QOL量表结果显示低视力者的主观视觉、周边视野、活动能力等得分更低(P<0.05),在评估视力状况对患者社会功能、心理精神方面的影响时缺乏敏感性(P>0.05);SQOL-DVI量表结果显示低视力者�Background Keratoprosthesis implantation is an effective way for patients with end-stage corneal blindness to regain sight,and the evaluation of vision-related quality of life(QOL)after surgery has become a research topic for ophthalmologists.Objective To compare the effects of NEI-VFQ-25,SQOL-DVI,VF-QOL in evaluating the QOL of patients with Mihe Kpro.Methods The patients who underwent MIOK keratoprosthesis implantation in our hospital from January 2015 to December 2019 were enrolled,and NEI-VFQ-25,SQOL-DVI,and VF-QOL scales were used to conduct a questionnaire survey to evaluate their QOL after surgery.QOL was compared between the patients with different levels of visual acuity(VA),with VA=0.3 as the cut-off value.Results A total of 48 patients were enrolled,among whom there were 43 male patients(89.58%)and 5 female patients(10.42%),and their age ranged from 21 to 81 years,with a mean age of 47.08±13.08 years.The total scores of NEI-VFQ-25,VF-QOL,and SQOL-DVI were 50.81±20.86,68.37±20.02,and 101.38±36.65,respectively,and VF-QOL scale had a significantly higher percentage of mean total score in full score than NEI-VFQ-25 and SQOL-DVI scales(68.37%vs 50.81%/50.69%),suggesting that QOL was at a moderate level for patients who regained sight after MIOK keratoprosthesis implantation.Comparison of the patients with different levels of VA showed that the patients with VA<0.3 had significantly lower scores[Md(IQR)]of each scale than those with VA≧0.3[NEI-VFQ-25:40.00(28.00-50.25)vs 60.50(39.75-76.25),P=0.011;VF-QOL:68.48(56.45-84.64)vs 80.52(63.46-86.53),P=0.020;SQOL-DVI:53.75(38.50-67.00)vs 99.00(70.25-128.75),P<0.001].As for the evaluation of each dimension,the results of NEI-VFQ-25 showed that the patients with low vision(VA<0.3)tended to have lower scores of overall vision,near activities,long-distance activities,social function,role limitation,and driving function(P<0.05),with a lack of sensitivity in assessing the impact of vision on mental health(P>0.05);the results of VF-QOL showed that the patients with

关 键 词：人工角膜植入术 NEI-VFQ-25量表 SQOL-DVI量表 VF-QOL量表 生活质量 

分 类 号：R779.65[医药卫生—眼科]