一个以患者为中心的治疗前下切除综合征方案的影响:一个多中心,单盲,随机对照试验
Richard Garfinkle1, Marie Demian1, Sarah Sabboobeh1
1Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada.
Annals of surgery
|June 12, 2025
概括
一个以患者为中心的新计划显著改善了手术后患有低前切除综合征 (LARS) 的患者的生活质量. 这种由护士指导的自我管理干预为LARS治疗提供了更好的方法.
科学领域:
- 结肠直肠手术的结果
- 患者自我管理干预措施
- 生活质量 (QoL) 研究
背景情况:
- 低前切除综合征 (LARS) 显著影响患者手术后的生活质量.
- 目前的LARS自我管理策略往往没有指导,并取得有限的成功.
- 需要一个结构化的,以患者为中心的方法来有效地解决LARS症状.
研究的目的:
- 评估LARS患者中心计划 (LARS-PCP) 对全球生活质量 (QoL) 的影响.
- 为了比较LARS-PCP,一个信息和指导的自我管理干预,与标准护理.
- 为了评估QOL结果6和12个月后的ostomy关闭后的恢复性分泌切除术.
主要方法:
- 一个多中心随机对照试验,涉及160名成年患者,接受了关闭的修复性分泌切除术.
- 参与者被随机分配1:1到LARS-PCP (信息工具和护理支持) 或标准护理.
- 患者报告的结果,包括全球QoL,在12个月的随访期间进行了测量.
主要成果:
- 拉斯-PCP组在6个月 (79.7比67.8,P=0.001) 和12个月 (82.0比74.9,P=0.036) 的口腔关闭后显著提高了全球QOL.
- 在LARS-PCP组中,在术后1个月观察到较低的LARS主要发病率 (60.0%vs81.7%,P=0.008).
- 与LARS-PCP相关的QOL改善在整个随访期内持续存在.
结论:
- 通过LARS-PCP进行护士指导的自我管理,可以显著改善恢复性分泌切除术后的QoL.
- 这项研究提供了第一个多中心随机对照试验证据,证明了结构化LARS干预的有效性.
- LARS-PCP在管理LARS和改善患者康复方面取得了宝贵的进步.
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