本文選題：捆綁式胰胃吻合 + 健康相關(guān)生活質(zhì)量��； 參考：《浙江大學(xué)》2015年碩士論文

【摘要】：目的 評(píng)估捆綁式胰胃吻合(BPG)術(shù)后患者的健康相關(guān)生活質(zhì)量(HRQoL). 方法 選取2013年6月至2015年3月我院普外科行Ⅱ型BPG的患者為研究組。以手術(shù)當(dāng)天為研究起點(diǎn),每隔6個(gè)月通過電話隨訪和中文版SF-36量表評(píng)估術(shù)后癥狀及生活質(zhì)量。對(duì)照組為1688例健康居民的杭州市SF-36常模。 結(jié)果 截至2015年4月,入組患者18例,中位隨訪時(shí)間14個(gè)月,最短隨訪1個(gè)月,最長(zhǎng)隨訪22個(gè)月。其中2例患者出現(xiàn)慢性腹瀉,2例腫瘤患者復(fù)發(fā)死亡。共收集15例患者術(shù)后6月的HRQoL資料,13例患者術(shù)后12月的HRQoL資料,4例患者術(shù)后18月的HRQoL資料。13例患者術(shù)后隨訪超過12個(gè)月,其術(shù)后6月和12月的HRQoL資料,納入統(tǒng)計(jì)分析,與對(duì)照組比較。統(tǒng)計(jì)結(jié)果表明患者術(shù)后6月的生理職能評(píng)分低于對(duì)照組(0.05),而其它維度的評(píng)分與對(duì)照組無差異(0.05)�；颊咝g(shù)后12月的生理職能和情感職能評(píng)分均低于對(duì)照組(0.05),而其它維度的評(píng)分與對(duì)照組無差異(0.05)。 結(jié)論 BPG操作簡(jiǎn)便,具有無針眼、膽胰分流,不受胰腺殘端限制,兩道捆綁等多重特點(diǎn)與優(yōu)點(diǎn),已被臨床證實(shí)在預(yù)防術(shù)后胰漏上效果明顯。BPG對(duì)術(shù)后胰腺功能基本無影響,但仍需長(zhǎng)期臨床觀察與驗(yàn)證。BPG術(shù)后患者的生理職能和情感職能下降可能與胰十二指腸切除術(shù)本身和心理因素關(guān)聯(lián)更大,BPG對(duì)術(shù)后HRQoL基本無影響,但其遠(yuǎn)期作用還需進(jìn)一步的觀察與驗(yàn)證。
[Abstract]:Objective to evaluate the health related quality of life (HRQoL) of patients after binding pancreaticogastric anastomosis (BPG). Methods from June 2013 to March 2015, patients with type II BPG in general surgery department in our hospital were selected as study group. The postoperative symptoms and quality of life (QOL) were evaluated by telephone follow-up and Chinese version of SF-36 every 6 months. The control group of 1688 healthy residents of Hangzhou SF-36 norm. Results as of April 2015, 18 patients were enrolled, the median follow-up time was 14 months, the shortest follow-up was 1 month, and the longest follow-up was 22 months. Among them, 2 patients with chronic diarrhea and 2 patients with recurrent tumor died. A total of 15 patients were followed up for more than 12 months after operation for 6 months and 13 patients were followed up for more than 12 months. The HRQoL data of 13 patients at 12 months after operation and 12 months after operation were included in the statistical analysis. Compared with the control group. The results showed that the score of physiological function was lower than that of the control group at 6 months after operation, but there was no difference between the other dimensions and the control group (0.05). The scores of physiological and affective functions in 12 months after operation were lower than those in the control group (0.05), but the scores of other dimensions were not different from those of the control group (0.05). Conclusion BPG is easy to operate and has many advantages, such as no needle eye, biliary and pancreatic shunt, no limitation of pancreatic stump, and two-channel binding. It has been clinically proved that the effect of preventing pancreatic leakage after operation is obvious. BPG has no effect on pancreatic function after operation. But it still needs long-term clinical observation and verification. The decline of physiological and emotional functions of patients after BPG may be more related to the pancreaticoduodenectomy itself and psychological factors. BPG has no effect on HRQoL after operation. But its long-term effect still needs further observation and verification.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R657.5

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