摘要
目的评估儿童肝移植受者术后健康相关生命质量,并分析相关影响因素。方法使用问卷调查的方式对2013年6月至2021年9月在首都医科大学附属北京友谊医院肝移植中心进行第一次肝移植手术并规律复查的5~17岁儿童肝移植受者的生命质量进行家长版问卷调研,排除不愿参加调查及无法理解问卷内容的患儿及家长。调查问卷基于9维儿童健康效用量表(Child Health Utility 9D instrument,CHU9D)设计,由患儿的1位主要照护者在线作答。使用CHU9D中国积分体系将问卷结果转化为健康效用值。先进行单因素分析,再将单因素分析结果中P<0.1的因素和经临床专家讨论认为具有临床意义的因素纳入多因素分析,使用多重线性回归模型,P<0.05为有统计学意义。结果共纳入140份有效问卷,受者年龄为(7.95±2.74)岁,调查距离移植手术时间为(4.90±2.17)年,其中19例至少发生过1次排斥反应,101例(72.1%)为亲体肝移植受者。CHU9D量表评估显示健康效用值为(0.85±0.14)分,单因素分析显示儿童肝移植受者接受调查的年龄、上学情况和原发病是儿童肝移植受者术后生命质量总分的影响因素(P=0.008、P<0.001和P=0.010)。多因素分析显示儿童肝移植受者的生命质量与上学情况相关,特别是进度落后(95%CI:-0.146~-0.034,P=0.002)和休学(95%CI:-0.251~-0.068,P=0.001)。结论儿童肝移植受者健康效用值较高,提示生命质量较好。学业进度落后或休学与儿童肝移植受者的低生命质量相关。
Objective To explore health utility value,evaluate health-related quality-of-life(QOL)of pediatric liver transplantation(LT)recipients and examine its influencing factors to provide rationales for related health economic evaluations.Methods This cross-sectional QOL was conducted through a questionnaire in pediatric LT recipients aged 5-17 years.The interviewees undergoing initial LT from June 2013 to September 2021 were reviewed regularly.Those children and their parents unwilling to participate or failing to understand the contents of questionnaire were excluded.The questionnaire was designed on the basis of Child Health Utility 9D Instrument(CHU9D)and answered online by one of primary caregiver.Chinese score system of CHU9D was employed for converting the responses into health utility values and the influencing factors were analyzed.Univariate analysis was performed by nonparametric tests and multivariate analysis by multiple linear regression model.P<0.05 was deemed as statistically significant.Results A total of 140 valid questionnaires were obtained.Mean age of pediatric LT recipients was(7.95±2.74)years and mean postoperative time(4.90±2.17)years.Among them,19 cases had experienced acute rejection and 101(72.1%)cases were living-related LT recipients.CHU9D scale indicated that average health utility value was(0.85±0.14)points.Univariate analysis revealed that age(P=0.008),education level(P<0.001)and primary disease(P=0.010)influenced the postoperative level of QOL.Multivariate analysis indicated that QOL was correlated with education level(behind schedule:95%CI:-0.146,-0.034,P=0.002;leave of absence:95%CI:-0.251,-0.068,P=0.001).Conclusions Health utility of pediatric LT recipients is high with an excellent QOL.Poor QOL is associated with absence from school or dropping out of school.
作者
刘冉佳
潘晨
徐烨
郭明星
崔向丽
朱志军
Liu Ranjia;Pan Chen;Xu Ye;Guo Mingxing;Cui Xiangli;Zhu Zhijun(Department of Pharmacy,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Liver Transplantation Center,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《中华器官移植杂志》
CAS
2023年第2期102-108,共7页
Chinese Journal of Organ Transplantation
基金
国家自然科学基金(81970562)
北京市通州区科技计划项目(KJ2022CX039)
北京友谊医院科研启动基金项目(yygdktgl2021-3)。
关键词
儿童
肝移植
生命质量
问卷调查研究
Child
Liver transplantation
Quality of life
Survey research
