Brit J Surg:全胰腺切除术后功能结局和生活质量评价

2019-09-15 xing.T MedSci原创

由此可见,全胰切除术后总体生活质量受到不利影响,尤其是腹泻。在全胰腺切除术后,糖尿病的管理还有改进的空间,特别是在预防糖尿病相关的疾病方面。

由于担心糖尿病和较差的生活质量(QoL),外科医生传统上不愿意进行全胰切除术。最近的几项研究表明,全胰切除术后的结局有所改善,但缺乏系统评价。

近日,外科疾病领域权威杂志British Journal of Surgery上发表了一篇研究文章,该分析对除慢性胰腺炎外所有报告了适合全胰切除术患者结局的研究进行系统评价。研究人员检索了PubMed、EMBASE(Ovid)和Cochrane图书馆(2005-2018)。终点包括功能结局和QoL。

该分析共纳入21项研究,包括1536名患者。在中位随访20.8(范围1.5-96.0)个月期间,18.6%(242名患者中的45名)的患者因内分泌相关的疾病重新入院,相关死亡率为1.6% (365名患者中的6名)。在仅包括2005年之后接受治疗患者的研究中未报告与糖尿病相关的死亡率。在中位随访15.9个月(1.5-96.0)期间,43.5%(329名患者中的143名)报告了与外分泌功能不全相关的症状。 研究人员使用EORTC QLQ-C30调查问卷,102名中位随访时间为28.6个月(6.0-66.0)的患者报告总体生活质量,显示总分降低了76%,与一般人群得分为86%(P=0.004)。

由此可见,全胰切除术后总体生活质量受到不利影响,尤其是腹泻。在全胰腺切除术后,糖尿病管理还有改进的空间,特别是在预防糖尿病相关的疾病方面。 

原始出处:

L. Scholten,et al.Systematic review of functional outcome and quality of life after total pancreatectomy. British Journal of Surgery.2019.https://doi.org/10.1002/bjs.11296

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    2019-09-17 huagfeg