A prospective study of quality of life in patients undergoing pelvic exenteration: interim results.
A prospective study of quality of life in patients undergoing pelvic exenteration: interim results.
复制标题
接受盆腔廓清术的患者生活质量的前瞻性研究：中期结果。
DOI：
10.1016/j.ygyno.2012.09.030
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发表时间：
2013
影响因子：
4.7
通讯作者：
Chi,DennisS
中科院分区：
文献类型：
--
作者：
Rezk,YoussefA;Hurley,KarenE;Carter,Jeanne;Dao,Fanny;Bochner,BernardH;Aubey,JaniceJ;Caceres,Aileen;Einstein,MHeather;Abu-Rustum,NadeemR;Barakat,RichardR;Makker,Vicky;Chi,DennisS
然而，关于盆腔清除术（PE）后生活质量（QOL）的前瞻性数据很少。这项正在进行的研究前瞻性地探讨了生活质量的变化后，这一激进的程序，使用一个全面的电池的心理instrument.METHODSSince 2005年，入组的患者进行了采访（EORTC QLQ-C30，EORTC QLQ-CR 38，EORTC QLQ-BLM 30，BFI，BPI-SF，IADL，CES-D，IES-R）术前和3，6，和12个月后PE的身体/心理症状。数据进行了检查，使用重复测量AN0VA.STA16名妇女（3前，1后，和12总PE），超过1年的后续行动，完成了所有预定的采访。中位年龄为58岁（范围，28- 76岁）。总体生活质量（F=6.3，p<0.02）、日常活动能力（F=6.8，p<0.02）、身体形象（F=11.9，p<0.00）和性功能（F=8.0，p<0.01）在PE后3个月均下降，但在12个月时接近基线。尽管总体而言，身体功能遵循类似的趋势（F=14.8，p<0.00），但并未恢复至基线水平。在12个月的访谈中，患者报告胃肠道症状增加（F=8.9，p<0.01），但与基线相比，与压力相关的想法明显减少（F=6.1，p<0.03）。疼痛水平在研究期间没有显著变化（F=0.4，p<0.74）。结论尽管患者报告PE后胃肠道症状挥之不去，身体功能持续下降，但大多数患者适应良好，在一年内几乎恢复到基线功能。提供者可以告知病人，随着他们适应健康状况的改变，在内脏切除后的前3个月内，许多（尽管不是全部）症状可能会得到改善。这些初步结果有待更大规模分析的确认。
OBJECTIVELittle prospective data exist on quality of life (QOL) after pelvic exenteration (PE). This ongoing study prospectively examines the QOL changes following this radical procedure using a comprehensive battery of psychological instruments.METHODSSince 2005, enrolled patients were interviewed (EORTC QLQ-C30, EORTC QLQ-CR38, EORTC QLQ-BLM30, BFI, BPI-SF, IADL, CES-D, IES-R) preoperatively and at 3, 6, and 12months after PE for physical/psychological symptoms. Data were examined using repeated measure ANOVA.RESULTSSixteen women (3 anterior, 1 posterior, and 12 total PEs), with more than 1 year of follow-up, completed all scheduled interviews. Median age was 58years (range, 28–76years). Overall QOL (F=6.3, p<0.02), ability to perform instrumental daily activities (F=6.8, p<0.02), body image (F=11.9, p<0.00), and sexual function (F=8.0, p<0.01) all declined at 3months but were near baseline by 12months after PE. Although, overall, physical function followed a similar trend (F=14.8, p<0.00), it did not return to baseline. At the 12-month interview, patients reported increased gastrointestinal symptoms (F=8.9, p<0.01) but significantly less stress-related ideation (F=6.1, p<0.03) compared to baseline. Pain levels did not change significantly during the study period (F=0.4, p<0.74).CONCLUSIONSAlthough patients report lingering gastrointestinal symptoms and some persistent decline in physical function after PE, most adjust well, returning to almost baseline functioning within a year. Providers can counsel patients that many, though not all, symptoms in the first 3months following exenteration are likely to improve as they adapt to their changed health status. These preliminary results await confirmation of a larger analysis.