Quality of life in laryngectomees after prosthetic voice restoration
Quality of life in laryngectomees after prosthetic voice restoration
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DOI：
10.1159/000072152
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发表时间：
2003-09-01
影响因子：
1
通讯作者：
Rosanowski, F
中科院分区：
文献类型：
--
作者：
Schuster, M;Lohscheller, J;Rosanowski, F
背景资料。在肿瘤学中，评估治疗结果的范例在过去几年中发生了变化。保持或恢复生活质量已成为与完全切除肿瘤和延长患者生存时间同等重要的医疗目标。喉切除术后，充分的语音恢复是治疗的主要目标之一。使用不同的发声替代策略，如气管食道发音、食道发音或电喉发声。报告部门能够恢复90%以上的患者的语音；大多数患者使用带Provox(R)语音假体的气管食道语音。这项研究的目的是评估使用Provox发音假体成功恢复嗓音后喉切除术患者的生活质量。患者和方法：在一项横断面研究中，对25例通过气管-食道穿刺术和Provox发音假体恢复嗓音的喉切除患者进行了生活质量检查。采用简式36项健康调查(SF-36)作为国际通用的、高度标准化的测验。结果：与标准的德国健康男性人群相比，患者表现出更多的身体功能受限，以及更多的身体和情感角色功能受限。然而，喉切除术并没有在身体疼痛方面获得更低的分数。根据患者的陈述，他们的社会功能、活力和心理健康并没有受到过多的限制，心理健康和活力甚至好于心肾衰竭和丙型肝炎患者。总体健康状况与标准人群相当。结论：喉切除术后患者的身心健康状况较差。治疗的概念应该越来越多地集中在如何处理身体限制和患者的统觉上。成功地恢复了声音，最大限度地减少了社交、智力和活力的限制。SF-36是一种适合于生活质量评估的工具，以确定喉切除术患者生活质量的疾病依赖性和个体限制，并应导致个体化干预。版权所有(C)2003 S.Karger AG，巴塞尔。
Background. In oncology, the paradigms for evaluating the results of treatment have shifted over the last few years. Preserving or restoring the quality of life has become an equally important aim of medical treatment as complete excision of the tumor and the duration of patient survival. Following laryngectomy, adequate speech restoration is one major aim of therapy. Different replacement strategies of voice production such as tracheoesophageal speech, esophageal speech, or electrolarynx are in use. The reporting department is able to restore speech in more than 90% of the patients; the majority uses tracheoesophageal speech with Provox(R) voice prosthesis. The purpose of the study was to assess the quality of life in laryngectomees after successful voice restoration with Provox voice prosthesis. Patients and Methods: In a cross-sectional study 25 laryngectomees whose voice had been restored by tracheoesophageal puncture and Provox voice prosthesis were examined for quality of life. The Short Form 36-Item Health Survey (SF-36) was used as an international and highly standardized test. Results: In comparison with a standardized healthy German male population, the patients showed more limited physical functioning as well as more restricted physical and emotional role functions. However, the laryngectomees did not attain lower scores for bodily pain. According to the patients' statements their social functioning, vitality, and their mental health were not excessively limited; mental health and vitality were even better than in patients with heart or renal failure and hepatitis C. General health was fairly similar to a standard population. Conclusions: After laryngectomy, patients have deficits in physical and emotional well-being. Concepts of therapy should increasingly focus on how to deal with physical limitations and the patient's apperception. Successfully restored voice minimizes social, mental and vitality limitations. The SF-36 is a suitable instrument for quality of life assessment in order to define disease-dependent and individual limitations of quality of life in laryngectomees and should lead to individual interventions. Copyright (C) 2003 S. Karger AG, Basel.