Assessment of quality of life after surgery for patients with hepatic hemangioma

Weike Gao, C. Dai, Yong-qing Xu, Yang Zhao, X. Bu, Yang Su, Liang Zhao
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Abstract

Objective To evaluate the postoperative quality of life after surgery of patients with hepatic hemangioma. Methods The retrospective and descriptive study was conducted. The clinical data of 104 patients who underwent surgery for hepatic hemangioma at Shengjing Hospital of China Medical University from September 2011 to February 2017 were collected. There were 28 males and 76 females, aged (49±8)years, with a range of 27-78 years. Enucleation of hepatic hemangioma or hepatectomy was selected according to tumor location of patients. Observation indicators: (1) surgical and postoperative situations; (2) assessment of quality of life in patients; (3) assessment of quality of life in patients comorbid with other chronic digestive diseases. Measurement data with normal distribution were represented as Mean±SD, and measurement data with skewed distribution were represented as M (range). Repeated data were analyzed using repeated ANOVA. Count data were represented as absolute numbers. Results (1) Surgical and postoperative situations: of 104 patients, 67 underwent enucleation of hepatic hemangioma, 37 underwent hepatectomy. The tumor diameter, volume of intraoperative blood loss, duration of postoperative hospital stay were (10±4)cm, 200 mL (range, 10-3 000 mL), (11±5)days. Seven patients had complications, including 5 of massive abdominal ascites, 1 of abdominal infection, and 1 of pulmanory obstruction. There was no death occurred. (2) Assessment of quality of life in patients with hepatic hemangioma: the total scores of Gastrointestinal-related Quality of Life Index (GIQLI), the scores of subjective symptoms, physiological status, mental and psychological status, and social activities were 121.0±8.3, 69.2±4.1, 18.5±2.6, 19.5±1.8, and 13.8±1.4 at preoperation. The above indices were 121.9±6.9, 71.2±3.8, 17.2±2.5, 19.6±2.3, and 13.8±1.3 of 104 patients with hepatic hemangioma at one month after surgery, respectively. The above indices were 127.8±6.2, 73.2±3.6, 19.8±2.5, 20.8±2.4, and 14.1±1.0 at 6 months after surgery. There were significant differences in changing trends of above indices (F=68.4, 64.6, 71.4, 17.8, 3.3, P 0.05). The total scores of GIQLI, scores of subjective symptoms, physiological status, and mental and psychological status at 6 months after surgery showed significant differences compared with those of preoperation (t=-8.897, -9.919, -5.375, -5.024, P 0.05). The total scores of GIQLI, the scores of subjective symptoms, physiological status, mental and psychological status, and social activities at 6 months after surgery were significantly different from those at one month after surgery (t=-10.835, -6.787, -12.277, -4.560, -2.476, P 0.05) . The scores of subjective symptoms and physiological status at one month after surgery showed significant differences compared with those of preoperation (t=-2.612, 2.191, P 0.05). The total scores of GIQLI, scores of subjective symptoms, physiological status, and social activities at 6 months after surgery showed significant differences compared with those of preoperation (t=-4.002, -3.441, -4.604, -3.266, P 0.05). The total scores of GIQLI, the scores of subjective symptoms, physiological status, and social activities at 6 months after surgery were significantly different from those at one month after surgery (t=-4.819, -2.313, -7.081, -3.172, P 0.05). Conclusions The quality of life in patients with hepatic hemangioma can be improved by surgery. Surgical treatment is still effective for improvement of the total scores of GIQLI, the scores of subjective symptoms, physiological status, and social activities for those combined with other digestive diseases. Key words: Hepatic hemangioma; Surgery; Enucleation of hepatic hemangioma; Hepatectomy; Quality of life
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肝血管瘤患者术后生活质量评价
目的评价肝血管瘤患者术后生活质量。方法采用回顾性和描述性研究。收集2011年9月至2017年2月在中国医科大学附属盛京医院行肝血管瘤手术治疗的104例患者的临床资料。男性28例,女性76例,年龄(49±8)岁,年龄27 ~ 78岁。根据患者的肿瘤部位选择肝血管瘤去核或肝切除术。观察指标:(1)手术及术后情况;(2)患者生活质量评估;(3)合并其他慢性消化系统疾病患者的生活质量评估。正态分布计量资料用Mean±SD表示,偏态分布计量资料用M(极差)表示。重复数据采用重复方差分析。计数数据以绝对数字表示。结果(1)手术及术后情况:104例患者中67例行肝血管瘤去核术,37例行肝切除术。肿瘤直径(10±4)cm,术中出血量(200 mL),术后住院时间(11±5)d。7例患者出现并发症,其中腹部大量腹水5例,腹部感染1例,肺梗阻1例。没有人员死亡。(2)肝血管瘤患者生活质量评价:术前胃肠道相关生活质量指数(GIQLI)总分、主观症状评分、生理状态评分、精神心理状态评分、社会活动评分分别为121.0±8.3、69.2±4.1、18.5±2.6、19.5±1.8、13.8±1.4。104例肝血管瘤患者术后1个月上述指标分别为121.9±6.9、71.2±3.8、17.2±2.5、19.6±2.3、13.8±1.3。术后6个月,上述指标分别为127.8±6.2、73.2±3.6、19.8±2.5、20.8±2.4、14.1±1.0。各指标变化趋势差异有统计学意义(F=68.4、64.6、71.4、17.8、3.3,P < 0.05)。术后6个月GIQLI总分、主观症状评分、生理状态评分、精神心理状态评分与术前比较差异均有统计学意义(t=-8.897、-9.919、-5.375、-5.024,P 0.05)。术后6个月GIQLI总分、主观症状评分、生理状态评分、精神心理状态评分、社会活动评分与术后1个月比较差异均有统计学意义(t=-10.835, -6.787, -12.277, -4.560, -2.476, P 0.05)。术后1个月主观症状和生理状态评分与术前比较差异有统计学意义(t=-2.612, 2.191, P 0.05)。术后6个月GIQLI总分、主观症状评分、生理状态评分、社交活动评分与术前比较差异均有统计学意义(t=-4.002, -3.441, -4.604, -3.266, P 0.05)。术后6个月GIQLI总分、主观症状评分、生理状态评分、社交活动评分与术后1个月比较差异有统计学意义(t=-4.819, -2.313, -7.081, -3.172, P < 0.05)。结论肝血管瘤手术治疗可提高患者的生活质量。对于合并其他消化系统疾病的患者,手术治疗对于改善GIQLI总分、主观症状评分、生理状态评分和社交活动评分仍然有效。关键词:肝血管瘤;手术;肝血管瘤去核术;肝切除术;生活质量
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中华消化外科杂志
中华消化外科杂志 Medicine-Gastroenterology
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