论文部分内容阅读
目的探讨部分脾栓塞术(partial splenic embolization,PSE)对门静脉高压患者生存质量的影响。资料与方法采用消化病生存质量指数(gastrointestinal quality of life index,GLQI)测定49例门静脉高压并脾亢患者PSE前及术后2~48周的生存质量值,按栓塞剂的不同随机分为明胶海绵组(明胶组)22例,聚乙烯醇(PVA)组27例,并比较不同栓塞剂对患者生存质量的影响。结果术后第2周,两组间平均GLQI及其他生存质量指数差异均无统计学意义(P>0.05),但两组各项生存质量指数,除心理情绪状态均明显低于术前,尤以PVA组为著。术后第4周,PVA组的GLQI总分均明显低于术前(P<0.05),但明胶组已恢复到术前水平。术后第8周,明胶组主观症状及GLQI总分均较术前显著升高(P<0.05),PVA组较术前略有升高(P>0.05)。术后第24周及48周,PVA组主观症状、社会活动状态、心理情绪状态及GLQI总分均高于术前(P<0.01),且较同期明胶组显著增高(P<0.05),但明胶组已恢复到术前水平。结论 PVA作为一种永久栓塞剂,栓塞效果稳定、持久,较明胶海绵颗粒更有利于改善患者术后的生存质量。
Objective To investigate the effect of partial splenic embolization (PSE) on the quality of life in patients with portal hypertension. Materials and Methods The quality of life of 49 cases of portal hypertension and hypersplenism patients before and after PSE were measured by GLQI and divided into gelatin according to different embolization agents Sponge group (gelatin group) 22 cases, polyvinyl alcohol (PVA) group 27 cases, and compare the different embolic agents on the quality of life of patients. Results There were no significant differences in mean GLQI and other QOL scores between the two groups at the second week after operation (P> 0.05). However, all the QOL scores, except the psychological and emotional status, were significantly lower than those before operation To PVA group as a. At 4 weeks after operation, the total GLQI score of PVA group was significantly lower than that of preoperative (P <0.05), but the gelatin group returned to the preoperative level. At the 8th week after operation, the subjective symptoms and the GLQI score of gelatin group were significantly higher than those before operation (P <0.05). The PVA group was slightly higher than that before operation (P> 0.05). At 24 weeks and 48 weeks after surgery, the scores of subjective symptoms, social activities, mental state and GLQI in the PVA group were significantly higher than those in the preoperative (P <0.01) and significantly (P <0.05) Gelatin group has returned to preoperative level. Conclusion PVA as a permanent embolic agent, embolization effect is stable and durable, more conducive to improving the quality of life of patients after gelatin sponge particles.