Long-term functional outcome and quality of life in patients with high imperforate anus
Long-term functional outcome and quality of life in patients with high imperforate anus
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DOI：
10.1016/j.jpedsurg.2009.10.041
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发表时间：
2010-01-01
影响因子：
2.4
通讯作者：
Teitelbaum, Daniel H.
中科院分区：
文献类型：
--
作者：
Hashish, Mohamed S.;Dawoud, Hamada H.;Teitelbaum, Daniel H.
目的：肛门直肠畸形（ARM）与大量的功能性后遗症，可能会影响儿童的长期生活质量（QOL）。本研究的目的是更好地量化患者功能性排便的结果，并确定这些结果如何与高imperialanus.Methods患者的生活质量相关：48例来自2家儿童医院进行了4年的生活后排便评分。评分包括13项问卷，以评估长期排便习惯（评分范围：0-30，最差到最好）。这些结果与由父母或监护人判断的QOL调查结果相关：调查时的平均（SD）年龄为6.5（1.6）岁。两所医院的生活质量和临床评分比较无显著性差异（P > 0.05）。生活质量与排便评分之间存在直接相关性（Pearson r（2）= 0.827; β系数= 24.7，P <0.001）。有趣的是，功能性排便评分随着年龄的增加而恶化（Pearson r（2）= 0.318，P = 0.02）。伴有先天性畸形的患者生活质量差的发生率较高（44%在差范围内; P = 0.001）。排便评分显着下降，增加严重性/复杂性的ARM（P = .001）。结论：大量的儿童经历功能性排便问题，这些都直接与不良的生活质量。与以前的看法相反，我们的研究表明，排便模式被认为随着年龄的增长而恶化。这表明患有ARMs的儿童需要长期的随访和咨询。(C)2010年爱思唯尔公司All rights reserved.
Purpose: Anorectal malformations (ARMs) are associated with a large number of functional sequale that may affect a child's long-term quality of life (QOL). The purposes of this study were to better quantify patient functional stooling outcome and to identify how these outcomes related to the QOL in patients with high imperforate anus.Methods: Forty-eight patients from 2 children's hospitals underwent scoring of stooling after 4 years of life. Scoring consisted of a 13-item questionnaire to assess long-term stooling habits (score range: 0-30, worst to best). These results were then correlated with a QOL survey as judged by a parent or guardian.Result: Mean (SD) age at survey was 6.5 (1.6) years. Comparison of QOL and clinical scoring showed no signficant difference between the 2 institutions (P > .05). There was a direct correlation between the QOL and stooling score (Pearson r(2) = 0.827; beta coefficient = 24.7, P < .001). Interestingly, functional stooling scores worsened with increasing age (Pearson r(2) = 0.318, P = .02). Patients with associated congenital anomalies had a high rate of poor QOL (44% in poor range; P = .001). Stooling scores decreased significantly with increasing severity/complexity of the ARM (P = .001).Conclusion: A large number of children experience functional stooling problems, and these were directly associated with poor QOL. In contrast to previous perceptions, our study showed that stooling patterns are perceived to worsen with age. This suggests that children with ARMs need long-term follow-up and counseling. (C) 2010 Elsevier Inc. All rights reserved.