Evaluation of quality of life in patients with hepatitis using specific questionnarire SF-LDQOL

Catedra de chirurgie nr. 2, USMF „Nicolae Testemiţanu”, Chișinău, Republica Moldova, Conferința stiințifică „Nicolae Anestiadi – nume etern al chirurgiei basarabene” consacrată centenarului de la nașterea profesorului Nicolae Anestiadi 26 august 2016Introducere. Contribuția măsurării calității vieții (CV) în elaborarea deciziei terapeutice rămâne un subiect important atât pentru pacient cât și pentru medici . Scop: Evaluarea CV pacienților cirotici chirurgical asistați prin chestionare realizate specific pentru afecțiunile hepatice. Material și metodă. 65 de pacienți operați pentru ciroză hepatică și hipertensiune portală, au agreat sã participe la un studiu de evaluare a CV alături de 20 de subiecți normali. Lotul pacientilor încadrați în studiu a fost divizat în 3 grupe reprezentând pacienți care au suportat diferite intervenții chirurgicale: devascularizare azygoportală (45), șunt portosistemic ( 8) și transplant hepatic (12 ). Instrumentul de evaluare a fost chestionarul specific, modificat în clinică, SF- LDQOL. Rezultate. Analiza chestionarului privind CV a evidențiat că majoritatea pacientilor operați pentru ciroză hepatică în primii 3 ani postoperator au un trend pozitiv al calității vieții. Evaluarea CV în funcție de tratament indică diferențe notabile între pacienții apartinând diferitelor compartimente de îngrijire chirurgicală: scorul total al CV și subscorurile sale au fost mai puțin afectate la pacienții cu transplant comparativ cu cele ale pacienților din celelalte grupe. Subliniem că completarea tratamentului chirurgical cu tratamentul endoscopic și cu tratamentul antiviral, îmbunătățește semnificativ CV pacientului operat , iar evoluție postoperatorie complicată marcat afectează indicele CV, moment care atrage atenția asupra importanței screeningului hepatic postterapeutic. Concluzii. Scorul SF-LDQOL este un instrument fidel de cuantificare a CV și o componentă importantă a deciziei terapeutice.Introduction. Contribution of measuring quality of life (QOL) in developing therapeutic decision remains an important issue for both patients and physicians.Purpose. Assess of CV of cirrhotic patients assisted surgically by questionnaires performed specific for liver disease. Methods. 65 patients operated for liver cirrhosis and portal hypertension, agreed to participate in a study to assess the CV along with 20 normal persons. The group of patients enrolled in the study was divided into 3 groups representing the patients who have undergone for different surgical interventions: azygoportal devascularisation (45), portosystemic shunt (8) and liver transplantation (12). The type of assessment was specific questionnaire, clinically modificated, SF LDQOL. Results. Analysis of CV showed that most of patients operated for liver cirrhosis in the first 3 years after surgery had positive changes in quality of life. CV based treatment evaluation indicates notable differences between patients belonging to different compartments of surgical care: total score of CV and its subscores were less affected in group of transplanted patients compared with those from other groups. We emphasize that completing of surgery with endoscopic treatment and antiviral therapy significantly improves the CV of operated patient, but complicated postoperative evolution severely affects the patients’ CV indexes, a moment that highlights the importance of post therapeutic liver screening. Conclusions. SF-LDQOL score is a reliable instrument to quantify of patients’ CV and an important component in therapeutic decision

Trends and results in actual treatment of splenoportal postsplenectomy trombosis

Introduction. The splenoportal venous thrombosis axle (TAVS) postplenectomy has an important role in general morbidity. There is still no common decision on the current treatment scheme. Purpose: To identify dynamically clinical-imagistic changes in the evolution of TAVS. Material and methods. In our study were included 74 splenectomized cirrhotic patients. For the 41 studied patients, we applied a strategy to prevent the occurrence of TAVS, namely: fraxiparin / peroxide cleanser, as prophylactic doses. We evaluated factors associated with treatment outcomes Results. 11 patients (14.8%) were diagnosed with TAVS after post-splenectomy, 5 men and 4 women with an average age of 42.3 ± 3.5 years. Approximate time from splenectomy was 6 months (1-13 months). TAVS patients used as therapy antiplatelet-dual-anticoagulant medication, in addition to the complex use of low molecular weight heparins also included oral administration of a platelet antiaggregant (150 mg ticlid, nugrel, plavix, clopidogrel 75 mg, aspirin). Decisions on time and duration of administration were taken on a case-by-case for each patient. The protocal analysis shows a positive response in 82% of cases that shows a amelioration of post-operative thrombocytosis, increasing the speed and volume of portal flow. Post-treatment retromyosis within 6 months was present in 2/11 patients. Conclusion. Factors that influenced the incidence of TAVS after postplenectomy were: significant splenomegaly, functional thrombocytosis, child score, perioperative prophylactic treatment

Studiul calităţii vieţii pacienţilor hepatici cu ajutorul chestionarului specific modificat SF-LDQOL

"Nicolae Anestiadi - nume etern al chirurgiei basarabene", conferinţă ştiinţifică (Chişinău) (2016