Long-term quality of life after total laryngectomy
Long-term quality of life after total laryngectomy
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DOI：
10.1002/hed.20268
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发表时间：
2006-04-01
影响因子：
2.9
通讯作者：
Backscheider, AG
中科院分区：
文献类型：
--
作者：
Vilaseca, I;Chen, AY;Backscheider, AG
背景有一种观点认为，全喉切除术对患者及其家属有毁灭性的影响，但只有少数研究涉及喉切除术后的长期生活质量（COL）。采用一般健康状况量表（简表-12，第2版[SF-12 v2]）对49例喉切除术后超过2年的患者进行了一项横断面研究。和疾病特异性COL工具（华盛顿大学生活质量问卷，第4版[UW-QOL v4.]）在一次全国性的喉切除术幸存者会议上。通过UW-QOL测量，患者将言语、外观和活动确定为全喉切除术后最重要的问题，但令人惊讶的是，言语和总体COL之间没有相关性。年龄是外观和焦虑的预测因素，女性更可能报告吞咽困难，放射患者报告更多的言语和焦虑困难，接受化疗的患者更有可能报告情绪困难。SF-12在物理总结领域（p = 21）中未发现正常受试者和喉切除者之间存在差异，但喉切除者在心理领域的得分更高（p = 0.004）。喉切除者在身体功能（p = 0.05）和身体角色（p = 0.036）方面的得分较低。当用一般健康仪器测量并与正常人群相比时，喉全切除术后的长期COL并没有降低，但当包括疾病特异性问卷或子量表评分时，发现物理量表受损。年龄、性别、放疗和化疗是UW-QOL分量表的独立预测因素。语音障碍被认为是一个问题，但不能预测整体COL。UW-QOL和SF-12（c）2005 Wiley Periodicals，Inc.之间存在很强的相关性。
Background. There is a perception that a total laryngectomy has a devastating effect on patients and their families, but only a few studies have addressed long-term quality of life (COL) after laryngectomy.Methods. A cross-sectional study of 49 patients more than 2 years since laryngectomy was performed with a general health status instrument (Short Form-12, version 2 [SF-12 v2.]) and a disease-specific COL instrument (University of Washington Quality of Life questionnaire, version 4 [UW-QOL v4.]) in a national meeting of laryngectomy survivors.Results. As measured by the UW-QOL, patients identified speech, appearance, and activity as the most important problems after total laryngectomy, but surprisingly, no correlation was seen between speech and overall COL. Age was a predictor of appearance and anxiety, women were more likely to report difficulties swallowing, irradiated patients reported more difficulties with speech and anxiety, and patients who received chemotherapy were more likely to report difficulties with mood. The SF-12 captured no differences between normal subjects and laryngectomees in the physical summary domain (p = 21) however, laryngectomees scored better in the mental domain (p =.004). Laryngectomees had lower scores in physical function (p = 005) and role physical (p =.036).Conclusions. Long-term COL is not decreased after total laryngectomy when it is measured with general health instruments and compared with the normal population, but impairment in physical scales is found when disease-specific questionnaires or subscale scores are included. Age, sex, radiation therapy, and chemotherapy are independent predictors of UW-QOL subscales. Voice handicap is identified as a problem but is not predictive of overall COL. A strong relationship exists between UW-QOL and SF-12 (c) 2005 Wiley Periodicals, Inc.