肝血管瘤患者瘤体剥除与介入栓塞术后生存质量对比评价

目的:比较肝血管瘤剥除术和肝动脉介入栓塞术(TAE)对肝血管瘤患者术后生存质量影响的差异。方法:采用问卷方式测定46例肝血管瘤患者术前及术后1、6、12、15个月的消化病生存质量指数(GLQI),46例患者中,23例行剥除术(剥除组)与23例TAE术(TAE组),比较两组患者生存质量的变化情况。结果:两组术前总GLQI差异无统计学意义(P0.05),但术后总GLQI总体变化趋势有明显差异(F=5.331,P0.05),剥除组术后1~15个月总GLQI稳步上升,TAE组术后1~6个月GLQI呈上升趋势,随后呈明显下降趋势。组间比较显示,剥除组术后1个月总GLQI低于TAE组[(99.5±11.2)vs.(109.0±9.2),P0.05],6个月时两组间无统计学差异[(112.2±8.8)vs.(114.4±10.8),P0.05],12、15个月剥除组高于TAE组[(128.5±8.3)vs.(108.7±10.4)、(129.2±8.5)vs.(108.2±9.5),均P0.05]。组内比较显示,剥除组术后12、15个月总GLQI较术前明显升高[(128.5±8.3)、(129.2±8.5)vs.(111.7±9.3),均P0.05];TAE组术后6个月总GLQI较术前明显升高[(114.4±10.8)vs.(108.3±9.8),P0.05],术后12、15个月与术前无统计学差异(均P0.05)。结论:血管瘤剥除术较TAE更有利于肝血管瘤患者术后远期恢复及生存质量的改善。

Comparison of quality of life in patients with liver hemangioma after enucleation and transcatheter arterial embolization

Objective: To compare the difference in impact on quality of life in patients with liver hemangioma after enucleation and transcatheter arterial embolization (TAE).Methods: Through a questionnaire method, the gastrointestinal quality of life index (GLQI) was measured in 46patients with hepatic hemangioma before and 1 month, and 6, 12, and 15 months after operation. Of the 46 patients, 23 cases underwent enucleation (enucleation group) and 23 cases received TAE (TAE group). The changes in quality of life of the two groups of patients were compared.Results: There was no statistical difference in total GLQI between the two groups (P>0.05), but the overall changing trend of the total GLQI after operation was significantly different between the two groups, which showed a continuous increase from the first to the last month after operation in enucleation group, while an increasing trend during the first to sixth month but a evident decreasing trend for later in TAE group (F=5.331, P<0.05). Comparison between the two groups showed that the total GLQI was lower in enucleation group than that in TAE group at postoperative one month [(99.5±11.2) vs. (109.0±9.2), P<0.05], had no significant difference between the two groups at postoperative 6 months [(112.2±8.8) vs. (114.4±10.8), P>0.05], and was higher in enucleation group than that in TAE group at postoperative 12 or 15 months [(128.5±8.3) vs. (108.7±10.4), (129.2±8.5) vs. (108.2±9.5), P<0.05]. Intra-group comparison showed that in enucleation group, the total GLQI at postoperative 12 and 15 months was significantly increased compared with its preoperative one [(128.5±8.3), (129.2±8.5) vs. (111.7±9.3), P<0.05], and in TAE group, it was significantly increased at postoperative 6 months compared with its preoperative value [(114.4±10.8) vs. (108.3±9.8), P<0.05], but declined to its preoperative level at postoperative 12 and 15 months (both P>0.05).Conclusion: Enucleation is better than TAE for long-term postoperative recovery and improvement of quality of life in liver hemangioma patients.