LIFE QUALITY OF PATIENTS AFTER ACUTE DESTRUCTIVE PANCREATITIS
About the author:
Kazimzade J. R.
Heading:
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Scentific article
Annotation:
The aim of the research: to evaluate the effectiveness of complex treatment of patients with pancreatic necrosis based on the study of quality of life in this category of patients. Object and methods. In the long-term period, in patients after a previous ADP (observation period ranged from 4 months to 6 years), the quality of life of patients was studied using the MOS SF-36 questionnaire (Medical Outcomes Study 36-item short form health survey). It consists of 36 questions and includes eight scales representing the physical and psychological components of health. Answers to questions are expressed in scores from 1 to 100. A higher score corresponds to a higher level of QOL. Scales are combined in two groups according to the meaning of the questions. Two obtained total indicators characterizing physical (physical activity) and mental (emotional state) health give an idea of the status of QOL against the background of the disease. The Mental Health category (Mental Health) reflects the presence of neurotization, a tendency to depressive states, a feeling of happiness, peace, and peace of mind. These categories represent the psychological component of health. The study included patients (main group – MG) with previously confirmed, reliably diagnosed ADP (n = 55), as well as a clinical comparison group (CCG) – patients without pathology from the gastrointestinal tract (n = 20). The groups were comparable by age and gender. The results are presented as a median with upper (75%) and lower (25%) quartiles. Results. The QOL indices in patients after the transferred ADP in almost all categories were significantly lower than in CCG. The components of QOL in first group were as follows: PF-85, RPF-70, BP-74, GH-75, VT-70, SF-72, REF66.6, MH80. In SCS, the similar components of QOL are as follows: PF-95, RPF-85, BP84, GH-87, VT-80, SF-87.5, REF 84.3, MH-88. Thus, the physical component of health in patients after the transferred ADP is significantly lower in all categories, and the psychological component in this category of patients is significantly lower in the category of social functioning. In the study of QOL in patients after an ADP, we proceeded from the assumption about the likely impact on the outcome of the disease of the volume of damage to the pancreas and retroperitoneal space and the severity of the condition, as well as the method of surgical treatment and the period after the pancreatic necrosis. It follows that QOL in patients of the first group is significantly lower in all categories of the physical component, but no significant differences were obtained in terms of the psychological component. When studying QOL, depending on the period after the transferred ODP, all patients were divided into three groups: the first group – up to 1 year, the second group – from 1 year to 3 years and the third group – patients after 5 years after the transferred ODP. The groups were comparable by age, gender, severity of the condition, as well as the volume of surgical intervention. Over time, these indicators increase and the highest values were found in patients of the third group. In addition, QOL was analyzed in patients with a recurrent course of pancreatitis. It was established that relapses of the disease (patients of the first group n = 24) significantly reduce both the physical and psychological components of QOL. Thus, the quality of life is significantly higher in patients who have undergone minimally invasive surgery. The quality of life is affected by both the severity of the condition and the degree of damage to the pancreas and parapancreatic fibers. With an increase in the period after acute destructive pancreatitis, the quality of life of patients increases. Relapses of the disease significantly reduce both the physical and psychological components of the quality of life in this category of patients. Conclusion. A comprehensive and individual approach to the treatment of patients with acute destructive pancreatitis can improve the quality of life in the postoperative period.
Tags:
pancreatitis, surgical treatment, quality of life
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 94-97 pages, index UDK 616.37-036.11-07-08