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与健康相关的生活质量在下肢截肢后的结果
Nike Walter1, Marion Görlich2, Carl Zülke3
1Department of Trauma Surgery, University Hospital Regensburg, Regensburg, Germany; Department of Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany.
概括
下肢截肢后的健康相关生活质量 (HRQoL) 受到伴随疾病的重大影响,而不仅仅是截肢水平. 专注于全身健康的多学科护理对于改善患者治疗结果至关重要.
科学领域:
- 整形外科 整形外科 整形外科
- 血管外科 血管外科
- 康复医学 康复医学 康复医学
背景情况:
- 下肢截肢显著影响患者的健康相关生活质量 (HRQoL).
- 在不同指示和截肢水平之间对HRQoL的比较数据是有限的.
- 了解影响HRQoL的因素对于优化患者护理至关重要.
研究的目的:
- 为了评估EQ-5D-3L在经历较大或较小的下肢截肢患者的结果.
- 为了比较患有缺血和没有缺血的患者之间的HRQoL.
- 为了确定下肢截肢者EQ-5D指数得分的预测因素.
主要方法:
- 德国一级创伤中心的回顾性队列研究 (2010-2020).
- 患者按适应症 (缺血与创伤/瘤/感染) 和截肢程度 (严重与轻微) 分类.
- EQ-5D-3L采访评估了HRQoL;多变量线性回归确定了预测因素.
主要成果:
- 在缺血和非缺血组的重大截肢中,移动性限制更为频繁.
- 在重大截肢时,疼痛/不适程度更高,特别是在缺血患者中.
- 在缺血患者中,美国麻醉学会 (ASA) 较高的得分预测了较低的EQ-5D;截肢水平没有.
- 在非缺血病患者中,冠心病和大截肢是EQ-5D的负预测因素.
结论:
- 截肢后的HRQoL损伤受指示和水平的影响.
- 伴随性疾病负担,特别是ASA得分和冠状动脉疾病,比截肢水平单独的影响更大.
- 在截肢护理中建议多学科优化全身健康.
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