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1.
目的探讨生物反馈训练治疗盆底肌痉挛综合症的临床疗效,并对便秘患者进行主观生存质量评价和客观肛门直肠测压检测。 方法将新疆医科大学第一附属医院便秘诊疗门诊收治的诊断明确的盆底肌痉挛综合症患者按患者意愿分为生物反馈训练治疗组和骶神经刺激治疗组,每组患者40例,对两组患者至少随访3个月,并使用生存质量自评表PAC-QOL中文版对入组病人进行生理、社会心理、担忧及满意度四方面进行主观评价和肛门直肠测压的客观评价。 结果主观方面,与骶神经刺激治疗组相比,生物反馈训练治疗可明显改善便秘患者生理、社会心理、担忧及满意度,提高患者生活质量;客观方面,生物反馈训练治疗更能增加直肠感觉阈值,降低肛管静息压和肛管最大收缩压,改善排便困难症状。 结论生物反馈训练治疗可明显改善盆底肌痉挛综合症患者的便秘症状,提高便秘患者的生活质量。  相似文献   

2.
目的通过与健康对照者比较,分析功能性便秘(FC)患者的精神心理和生活质量状况,揭示对FC患者的生活质量评价的临床意义。方法应用一个普适量表(SAS、SDS)和一个疾病特殊量表(PAC-QOL)对60例FC患者和年龄、性别、体重指数相匹配的30例健康对照组进行问卷调查,对两者之间的精神心理评分、生活质量评分进行比较,同时对FC患者的精神心理评分与生活质量评分进行相关性分析。结果(1)FC患者与健康对照者在年龄、性别比例、体重指数之间无显著性差异。(2)FC患者SAS、SDS标准分显著高于健康对照组。(3)FC患者PAC-QOL评分分别为:躯体不适3.06±0.75,心理社会不适2.34±0.79,担心焦虑2.99±0.81,满意度3.22±0.40,总平均分2.85±0.50,均较基线水平明显升高。(4)SAS、SDS标准分与PAC-QOL评分有显著相关性。结论FC患者存在明显的精神心理异常,便秘严重降低了患者的生活质量。生活质量评分的高低比实验室指标更能反映患者的健康状况。诊治功能性便秘时应重视患者生活质量的评价状况。  相似文献   

3.
目的探讨综合护理干预缓解中央型前置胎盘产前出血患者便秘的效果.方法选择2015-02/2018-02新昌县人民医院收治的中央型前置胎盘产前出血合并便秘患者60例,根据护理方法不同分为对照组30例和观察组30例.对照组实施常规护理干预,观察组在对照组基础上实施综合护理干预.采用便秘症状及疗效评估表评价两组护理前后便秘症状的改善情况;采用便秘患者症状自评量表(patient assessment of constipation symptom,PA C-S Y M)评价两组患者护理前后的自我感观;采用便秘患者生活质量量表(patient-assessment of constipation quality of life,PAC-QOL)评价两组患者护理前、后的生活质量,比较两组护理对便秘症状的缓解效果.结果观察组和对照组护理后排便困难或过度用力排便、大便性状、排便时间、排便频率、腹胀、下坠及不尽等评分均低于护理前(P0.05),其中观察组便秘症状及疗效改善情况明显优于对照组(P0.05);观察组与对照组护理后粪便性状、直肠症状及腹部症状等PAC-SYM评分均低于护理前(P0.05),其中观察组PAC-SYM评分改善情况明显优于对照组(P0.05);观察组和对照组护理后生理、担忧、社会心理和满意度等PAC-QOL评分均低于护理前(P0.05),其中观察组护理后PAC-QOL评分低于对照组(P0.05).结论综合护理干预能够有效缓解中央型前置胎盘产前出血患者的便秘症状,有效提高其生活质量,值得推广应用.  相似文献   

4.
目的 探讨肠通方联合双歧杆菌三联活菌胶囊治疗老年慢性功能性便秘的疗效。方法 88例老年慢性功能性便秘患者采用随机数字表法分为对照组和观察组各44例。对照组应用双歧杆菌三联活菌胶囊治疗,观察组应用肠通方联合双歧杆菌三联活菌胶囊治疗,两组均治疗2个月。比较治疗2个月时两组的临床疗效;比较治疗前、治疗2个月时两组便秘程度[Wexner便秘评分量表评估]及生活质量[便秘患者生存质量量表(PAC-QOL)评估];统计两组治疗期间不良反应的发生情况。结果 治疗2个月时,观察组总有效率明显高于对照组,整体疗效明显优于对照组(P<0.05);治疗2个月,两组Wexner便秘评分均较治疗前明显降低,且观察组Wexner便秘评分明显低于对照组(P<0.05);治疗2个月,两组PAC-QOL评分均较治疗前明显降低,且观察组PAC-QOL评分明显低于对照组(P<0.05);治疗期间,两组不良反应发生率差异无统计学意义(P>0.05)。结论 肠通方联合双歧杆菌三联活菌胶囊治疗老年慢性功能性便秘患者的疗效确切,可减轻患者便秘症状,提升其生活质量,且不会增加不良反应。  相似文献   

5.
功能性便秘患者的精神心理状况及生活质量评估   总被引:5,自引:0,他引:5  
目的 通过比较和分析功能性便秘(FC)患者与健康对照者的精神心理和生活质量状况,揭示FC患者的生活质量状况及其临床意义.方法 应用普适量表(SCL-90)和疾病特殊量表(PAC-QOL)对60例FC患者和性别、年龄相匹配的30例健康对照者进行问卷调查,并详细记录每天排便情况.对两者之间的一般资料、精神心理评分、生活质量评分进行比较,同时对FC患者的精神心理评分、便秘症状程度与生活质量评分进行相关性分析.结果 (1)FC患者与健康对照者在年龄、BMI、性别比例之问差异无统计学意义;而两组在大便性状评分、日均排便次数之间差异有统计学意义.(2)FC患者SCL-90评分的总分、总症状指数、阳性项日数、阳性症状痛苦水平、9个因子分除恐怖外的躯体化、强迫、焦虑、抑郁和精神病性等因子分显著高于健康对照组(P<0.05).(3)FC患者PAC-QOL的4个部分得分及总平均分分别为:躯体不适(3.06±0.75)、心理社会不适(2.34±0.79)、担心焦虑(2.99±0.81)、满意度(3.22±0.40)、总平均分(2.85±0.50),均较基线水平明显升高.(4)SCL-90中的总分、总症状指数、阳性项目数、阳性症状痛苦水平、9个因子分中的躯体化、强迫、抑郁、焦虑、敌对等与PAC-QOL评分有显著相关性,尤其表现在焦虑和抑郁两方面.(5)FC患者腹胀、排便费力等症状程度与PAC-QOL总平均分及SCL-90评分有显著相关性.结论 FC患者存在明显的精神心理异常,便秘严重降低了患者的生活质量.生活质量评分的高低比实验室指标和便秘的严重程度更能反映患者的健康状况.  相似文献   

6.
目的观察加减地黄饮子对老年帕金森病患者便秘的疗效。方法选择2018年12月-2020年12月在南京中医药大学附属南京市中医院收治的136例帕金森病便秘患者,采用随机数字表法将其分为观察组(n=68)与对照组(n=68),对照组患者应用美多芭和酚酞片治疗,观察组在对照组的基础上给予加减地黄饮子治疗,2组疗程均为28 d。比较2组便秘疗效、不良反应,及治疗前后的慢性便秘症状严重程度评分量表(CSS)评分和便秘患者生存质量量表(PAC-QOL)评分及帕金森病39项问卷评分(PDQ39)、肛门直肠动力学指标。结果观察组便秘治疗有效率显著高于对照组(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05);治疗前,2组肛管静息压、CSS评分、PDQ39评分、直肠初次排便感觉阈、PAC-QOL评分与肛管最大收缩压差异无统计学意义(P>0.05);治疗后,2组肛管最大收缩压及肛管静息压相较于同组治疗前显著升高(P<0.05),直肠初次排便感觉阈及CSS、PDQ39、PAC-QOL评分较同组治疗前显著下降(P<0.05),而观察组肛管最大收缩压及肛管静息压升高程度大于对照组(P<0.05),观察组直肠初次排便感觉阈及CSS、PDQ39与PAC-QOL评分下降程度大于对照组(P<0.05)。结论加减地黄饮子治疗老年帕金森病便秘的疗效显著,可改善患者便秘症状、肛门直肠动力学及生活质量,安全可靠,值得推广。  相似文献   

7.
目的探讨老年急性白血病化疗患者心理状况与生存质量的关系。方法老年急性白血病化疗患者190例,应用焦虑抑郁量表(HAD)评价患者的焦虑、抑郁情况,根据是否焦虑分为焦虑组和非焦虑组,应用癌症患者生存质量量表(EORTC QLQ-C30)测定患者的生存质量,分析焦虑与患者生存质量的相关性。结果 190例患者中73例(38.4%)存在焦虑,抑郁患者52例(27.4%);相关性分析显示,焦虑和抑郁呈正相关(P<0.05);焦虑组和非焦虑组功能子量表、症状子量表、总健康状况、呼吸困难、失眠、食欲丧失、便秘、经济困难及腹泻比较均具有统计学差异(P<0.05);焦虑评分与总健康状况呈负相关(r=-0.535,P<0.05),焦虑评分与功能子量表、症状子量表、呼吸困难、失眠、食欲丧失、便秘、经济困难、腹泻呈正相关(r=0.636,0.719,0.842,0.595,0.637,0.683,0.729,0.693,P<0.05)。结论老年急性白血病患者不良心理发生率较高,焦虑患者生存质量较低,临床应密切关注患者心理状况,提高患者生活质量。  相似文献   

8.
目的采用癌症患者生存质量测定量表(EORTC QOL-C30)中文版量表探讨综合护理干预联合常规护理在胃癌患者中的护理效果及对生存质量的影响.方法取2014-10/2016-12医院收治胃癌患者60例,随机数字法分为对照组(n=30)和观察组(n=30).对照组采用常规护理,观察组在对照组基础上联合综合护理干预,采用EORTC QOL-C30中文版量表对护理前、后生存质量进行评定,比较2组护理效果及对生存质量的影响.结果观察组护理后抑郁自评量表及焦虑自评量表评分,低于对照组(P0.05);观察组护理后躯体功能、情绪功能、认知功能、角色功能及社会功能评分,高于对照组(P0.05).观察组护理后1年、3年及5年生存率,高于对照组(P0.05).结论胃癌患者治疗过程中在常规护理基础上联合综合护理干预效果理想,有助于提高生存质量,值得推广应用.  相似文献   

9.
肺结核病是一种严重影响患者生存质量的慢性传染病。真实、准确反映肺结核患者的生存质量是评价肺结核临床疗效的重要手段。通过查阅相关文献,目前肺结核患者生存质量量表分为二大类,包括普适性量表和肺结核患者特异性量表。其中,普适性量表主要有简明健康状况调查表(SF-36),世界卫生组织生存质量测定量表,症状自评表,Karnofsky功能状态(Karnofsky performance status,KPS)量表,欧洲五维健康量表(EuroQol,EQ-5D),凯斯勒心理疾患量表(Kessler-10,K-10);肺结核患者特异性量表主要包括肺结核患者健康行为量表(HBSOT),结核病患者生存质量测评工具(QLI-TB)、DR-12量表、慢性疾病生活质量指标体系肺结核量表(QLICD-PT)。作者就肺结核患者常用的生存质量量表研究现状加以介绍,并且提出一些意见和建议,以更好地实现临床应用与评价。  相似文献   

10.
目的:探讨肝病生存质量量表(Liver Disease Quality of Life Questionnaire,LDQOL1.0)中文版在慢性病毒性肝炎患者生存质量测试中的信度和效度.方法:使用LDQOL1.0中文版对100例慢性病毒性肝炎患者进行进行生存质量测试,回收有效问卷91例,使用克朗巴赫系数(Cronbachα)、天花板效应和地板效应来检测量表的信度;通过计算各个肝病特异性维度与S F-36的8个维度之间的相关系数来评估量表的标准效度;通过探索性因子分析来评估量表的结构效度;通过比较不同Child Pugh评分的患者的得分,评估量表的区分度.相关性检测使用Pearson相关系数,区分度检测使用方差分析进行多重比较.结果:Cronbach α在各领域中的分值为0.33(95%C I:0.08-0.52)-0.9(95%C I:0.90-0.99),80%领域分值0.7;天花板效应在0%-39.6%,地板效应在0%-34.1%,80%领域20%.标准效度提示12个肝病特异性领域里,有6个领域与SF-36的相近领域相关度较好(Pearson系数0.5,P0.05);因子分析提示肝病特异性12个领域里7个领域因子分析结果与原量表构想相似.区分度检测提示肝病特异性12个领域里7个的区分度较好(F:0.353-21.29,P0.05).结论:LDQOL1.0在中国慢性病毒性肝炎患者中测试生存质量,大部分领域信度、效度和区分度较好,可以用于临床工作.  相似文献   

11.
OBJECTIVE: Chronic constipation is characterized by difficult, infrequent, or seemingly incomplete bowel movements. The Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire was developed to address the need for a standardized, patient-reported outcomes measure to evaluate constipation over time. MATERIAL AND METHODS: Items for the PAC-QOL were generated from the literature, clinical experts, and patients. Following principal components and multi-trait analyses, 28 items were retained forming four subscales (worries and concerns, physical discomfort, psychosocial discomfort, and satisfaction) and an overall scale. Validation studies were conducted in the United States, Europe, Canada, and Australia, to evaluate the internal consistency reliability (Cronbach's alpha), reproducibility (Intraclass Correlation Coefficients (ICCs)), validity (analysis of variance models), and responsiveness (effect size) of the PAC-QOL scales. RESULTS: The PAC-QOL scales were internally consistent (Cronbach's alpha >0.80) and reproducible (ICCs >0.70, except for the satisfaction subscale ICC=0.66). PAC-QOL scale scores were significantly associated with abdominal pain (p<0.001) and constipation severity (p<0.05). Effect sizes in patients reporting improvements in constipation over a 6-week period were moderate to large, with subscale effect sizes ranging from 0.76 to 3.41 and the overall scale effect size=1.77. Similar findings were observed in validation studies conducted in Europe, Canada, and Australia. CONCLUSIONS: The PAC-QOL is a brief but comprehensive assessment of the burden of constipation on patients' everyday functioning and well-being. Multinational studies demonstrate that the PAC-QOL is internally consistent, reproducible, valid, and responsive to improvements over time.  相似文献   

12.
OBJECTIVES: To assess suffering in demented nursing home patients with pneumonia treated with antibiotics or without antibiotics. This study should provide the first empirical data on whether pneumonia is a "friend" or an "enemy" of demented patients and promote a debate on appropriate palliative care. DESIGN: Prospective cohort study. SETTING: Psychogeriatric wards of 61 nursing homes in the Netherlands. PARTICIPANTS: Six hundred sixty-two demented patients with pneumonia treated with (77%) or without (23%) antibiotics. MEASUREMENTS: Using an observational scale (Discomfort Scale-Dementia of Alzheimer Type), discomfort was assessed at the time of the pneumonia treatment decision and periodically thereafter for 3 months or until death. (Thirty-nine percent of patients treated with antibiotics and 93% of patients treated without antibiotics died within 3 months.) Physicians also offered a retrospective judgment of discomfort 2 weeks before the treatment decision. In addition, pneumonia symptoms were assessed at baseline and on follow-up. Linear regression was performed with discomfort shortly before death as an outcome. RESULTS: A peak in discomfort was observed at baseline. Compared with surviving patients treated with antibiotics, the level of discomfort was generally higher in patients in whom antibiotic treatment was withheld and in nonsurvivors. However, these same patients had more discomfort before the pneumonia. Breathing problems were most prominent. Shortly before death from pneumonia, discomfort increased. Discomfort was higher shortly before death when pneumonia was the final cause of death than with death from other causes. CONCLUSION: Irrespective of antibiotic treatment, pneumonia causes substantial suffering in demented patients. Adequate symptomatic treatment deserves priority attention.  相似文献   

13.
Aims: The aim of this study was to assess the impact of myocardialinfarction (MI) on health-related quality of life (HRQL) inMI survivors measured by EuroQol (EQ-5D) and to compare it withthe general population. Methods and results: A follow-up study of all MI survivors included in the MONICA/KORAregistry was performed. About 2950 (67.1%) patients responded.Moderate or severe problems were most frequent in EQ-5D dimensionpain/discomfort (55.0%), anxiety/depression (29.2%), and mobility(27.9%). Mean EQ VAS score was 65.8 (SD 18.5). Main predictorsof lower HRQL included older age, diabetes, increasing bodymass index, current smoking, and experience of re-infarction.Type of revascularizational treatment showed no impact on HRQL.Compared with the general population, adjusted EQ VAS was 6.2(95% confidence interval 3.4–8.9) points lower in 45-year-oldMI patients converging with growing age up to the age of 80.With regard to HRQL dimensions, MI survivors had a significantlyhigher risk of incurring problems in the dimension pain/discomfort,usual activities, and especially in anxiety/depression whichwas more pronounced in younger age. Mobility was the singledimension, in which MI showed an inverse effect. Conclusion: MI is combined with significant reduction in HRQL compared withthe general population. The main impairments occur in the dimensionpain/discomfort, usual activities, and particularly anxiety/depression.The relative impairment decreases with higher ages.  相似文献   

14.
In times of the modern global societies, concern for QoL is a priority for gerontology, being an interdisciplinary field. The aim of this study was to assess the QoL of students of the U3A based on socio-demographic factors, subjectively reported diseases and/or discomfort, and well-being. The study comprised 257 students of the U3A in Poland, located in the city of Bydgoszcz. The study group consisted of 237 women and 20 men at an average age of 64.54 ± 6.01 years. The vast majority of the study group were married individuals and individuals with a secondary education. Just over half of the group stated that they are in good health and have no afflictions. All of the respondents were fully mobile. The QoL was assessed using the Polish version of the WHOQOL-Bref and the geriatric depression screening (GDS) scale. The QoL in its different areas balanced out at a medium level (average range: 13.30-13.87). The level of education of the U3A students proved to have a significant relation ith the environmental domain of QoL. No significant influence of age, gender, or marital statues on the QoL of the U3A students was found. A significant relation between subjectively reported diseases and/or discomfort with the QoL was demonstrated in the physical domain. Nearly 75% of the respondents showed no signs of depressive moods. The occurrence of depression indeed disrupted the QoL in all the studied domains, although least in the physical domain. Elderly individuals participating in permanent education display, in the face of progressive senile involution, average and at the same time stable parameters of QoL in all areas of functioning, which can be considered satisfactory, given this phase of life. The level of QoL of the U3A students significantly denotes the level of education of respondents, existing illnesses and afflictions, and the presents of depression.  相似文献   

15.
No remarkable improvement has yet been achieved in the survival of patients with advanced intrathoracic esophageal cancer. In particular, patients with complications such as esophago-bronchial fistula or invasion into the mediastinum have an especially miserable prognosis, even with surgical treatment. To improve the quality of life (QOL) of such patients, extensive palliative therapy should be provided. Thus, we have introduced an endoscopic esophageal intubation technique for the treatment of stenosis or perforation in patients with T4 esophageal cancer. Nine patients with unresectable intrathoracic esophageal cancer, complicated by stenosis or perforation, were treated with an endoscopic esophageal prosthesis. Four cases had an esophago-bronchial fistula, and in three the tumor had perforated the mediastinum. The prosthesis was successfully placed under endoscopic guidance in all nine cases. Six patients (66.7%) subsequently resumed oral intake without discomfort, while two had reasonably good outcomes in this regard (efficacy rate; 88.9%). Complications were seen in three patients: mainly chest discomfort, reflux esophagitis and migration of the prosthesis in one patient each. Six patients required prolonged administration of chemotherapeutic agents following prosthesis placement. Mean survival was 123.4±77.0 days. Four of the nine patients died in the hospital. Palliative endoscopic esophageal prosthesis was considered to be useful for patients with advanced esophageal cancer. With this technique, an improvement in QOL was achieved, as sufficient oral intake was facilitated and pulmonary and mediastinal complications due to perforation were diminished.  相似文献   

16.
OBJECTIVES: To quantify the associations between measures of oral health–related quality of life (OHRQoL) and life‐space mobility (LSM) in community‐dwelling older adults. DESIGN: Cross‐sectional study using a 54‐item OHRQoL questionnaire. SETTING: Five counties in central Alabama: Jefferson and Tuscaloosa (urban), and Bibb, Hale, and Pickens (rural). PARTICIPANTS: The 288 dental study volunteers were recruited from participants in the University of Alabama at Birmingham Study of Aging, a longitudinal study of mobility in community‐dwelling adults aged 65 and older. MEASUREMENTS: Participants completed an in‐home interview about their OHRQoL and LSM. Life‐space was assessed by asking questions about where and how often participants got to areas ranging from the home to beyond town and the degree of independence in getting there. Unadjusted and adjusted regression models were used to quantify associations between OHRQoL and LSM. Other factors examined were age, race, sex, income, education, residence, transportation difficulty, marital status, depressive symptoms, and comorbidity. RESULTS: Unadjusted and adjusted analyses suggested significant associations between OHRQoL and LSM in oral functional limitation, oral pain and discomfort, oral disadvantage, and self‐rated oral health. CONCLUSION: OHRQoL decrements that participants reported were associated with less LSM, suggesting that perceptions of oral well‐being have a significant effect on mobility and the social participation of older adults.  相似文献   

17.
AIM: To compare postoperative quality of life (QOL) in patients with gastric cancer treated by esophagogastrostomy reconstruction after proximal gastrectomy. METHODS: QOL assessments that included functional outcomes (a 24-item survey about treatment- specific symptoms) and health perception (Spitzer QOL Index) were performed in 149 patients with gastric cancer in the upper third of the stomach, who had received proximal gastrectomy with additional esophagogastrostomy. RESULTS: Fifty-four patients underwent reconstruction by esophagogastric anterior wall end-to-side anastomosis combined with pyloroplasty (EA group); 45 patients had reconstruction by esophagogastric posterior wall end-to-side anastomosis (EP group); and 50 patients had reconstruction by esophagogastric end-to-end anastomosis (EE group). The EA group showed the best postoperative QOL, such as recovery of body weight, less discomfort after meals, and less heart burn or belching at 6 and 24 mo postoperatively. However, the survival rates, surgical results and Spitzer QOL index were similar among the three groups. CONCLUSION: Postoperative QOL was better in the EA than EP or EE group. To improve QOL after proximal gastrectomy for upper third gastric cancer, the EA procedure using a stapler is safe and feasible for esophagogastrostomy.  相似文献   

18.
Objective: To validate the Oxford Knee Score (OKS) in outpatients with knee osteoarthritis (OA). Methods: Eligible patients were interviewed using a pretested questionnaire containing the OKS, the Short Form (SF)‐6D, and the EuroQol Group 5‐Dimension Self‐Report Questionnaire score (EQ‐5D). Reliability was assessed using Cronbach’s alpha, dimensionality using principal component factor analysis and item‐total correlations, convergent and discriminant construct validity using expected correlations between the OKS and the SF‐6D and the EQ‐5D. Results: The OKS were well accepted by patients in a pilot testing. When administered to a convenient sample of 187 patients with knee OA (mean age 64 years, 74% female, mean duration of OA 7.6 years), Cronbach’s alpha exceeded 0.8 and factor analysis yielded two factors with eigenvalues > 1. Hypothesized item‐total correlations (ρ ≥ 0.4) were observed for all items. Convergent construct validity was supported by the presence of hypothesized moderate to strong correlations between the OKS and SF‐6D physical functioning, role limitation, social functioning and pain, EQ‐5D mobility, self‐care, usual activities, and pain/discomfort, and mobility visual analogue scale (ρ = 0.47–0.82). Discriminant construct validity was not satisfactory. The OKS correlated weakly with SF‐6D vitality (ρ = 0.35), but strongly with SF‐6D mental health and EQ‐5D anxiety/depression (ρ = 0.51 and 0.41, respectively). Conclusion: The OKS has demonstrated good psychometric properties and thus can be considered a reliable and valid measurement for outpatients with OA.  相似文献   

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