Severe reflux, sleep disturbances, and health-related quality of life after esophageal cancer surgery.
Severe reflux, sleep disturbances, and health-related quality of life after esophageal cancer surgery.
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DOI：
10.1007/s11764-020-00974-9
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Schandl A
中科院分区：
文献类型：
--
作者：
Lagergren P;Johar A;Rosenlund H;Arnberg L;Haglund L;Ness-Jensen E;Schandl A
癌症食管切除术是一项广泛的手术，通常会出现严重的并发症。这项研究调查了患有严重反流症状的患者在食管切除术后是否更有可能出现睡眠障碍和健康相关生活质量（HRQL）下降。这项瑞典全国前瞻性队列研究涵盖了 2013 年至 2018 年间因癌症接受食管切除术的所有患者。手术一年后，患者回答了三份关于反流 (EORTC QLQOG25)、睡眠障碍 (KSQ) 和 HRQL (EORTC QLQ-C30) 的问卷。多变量逻辑回归提供了有和没有反流患者之间睡眠障碍/HRQL 降低的比值比 (OR) 和 95% 置信区间 (CI)，并针对潜在的混杂因素进行了调整。在 241 名食管切除术患者中，66 名（27%）报告出现严重反流。与无反流的患者相比，反流患者睡眠障碍的风险增加（OR 2.3，95% CI：1.3-4.3）。更具体地说，这些患者更有可能睡眠质量较差（OR 4.9，95% CI：1.9-12.4）。患有反流和睡眠障碍的患者报告称，总体生活质量、角色功能、情绪功能、社交功能以及除呼吸困难外的所有症状均有所下降。这项研究表明，食管切除术后出现严重反流症状的患者睡眠障碍和睡眠质量差的风险增加，而这又与 HRQL 降低有关。缓解食管癌手术后的反流非常重要，因为这种常见症状可能会降低 HRQL 和幸福感。
Esophagectomy for cancer is an extensive procedure often followed by severe complications. This study investigated whether patients with severe symptoms of reflux are more likely to have sleep disturbances and reduced health-related quality of life (HRQL) after esophagectomy. This Swedish nationwide prospective cohort study encompassed all patients who had undergone esophagectomy for cancer between 2013 and 2018. One year after surgery, the patients responded to three questionnaires on reflux (EORTC QLQOG25), sleep disturbances (KSQ), and HRQL (EORTC QLQ-C30). Multivariable logistic regression provided odds ratios (OR) with 95% confidence intervals (CI) for sleep disturbance/reduced HRQL between patients with and without reflux, adjusted for potential confounders. Among 241 esophagectomy patients, 66 (27%) reported severe reflux. Patients with reflux had an increased risk of sleep disturbances (OR 2.3, 95% CI: 1.3–4.3) compared to patients without reflux. More specifically, these patients were more likely to suffer from poor sleep quality (OR 4.9, 95% CI: 1.9–12.4). Patients with reflux and sleep disturbances reported reductions in global quality of life, role function, emotional function, social function, and more symptoms in all scales, except for dyspnea. This study suggests that patients with severe symptoms of reflux after esophagectomy have an increased risk of sleep disturbances and poor sleep quality, which in turn are associated with reduced HRQL. Alleviating reflux after oesophageal cancer surgery is important, since this common symptom might reduce HRQL and well-being.
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1.1
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