| 孙松朋,龙俊红,范淑勤,等.基于生命质量和临床症状探讨痔病 Goligher分级[J].安徽医药,2022,26(11):2243-2248. |
| 基于生命质量和临床症状探讨痔病 Goligher分级 |
| Goligher classification of hemorrhoids based on quality of life and clinical symptoms |
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| DOI：10.3969/j.issn.1009-6469.2022.11.028 |
| 中文关键词: 痔 病人病情 Goligher分级 生命质量 临床症状 |
| 英文关键词: Hemorrhoids Patient acuity Goligher classification Quality of life Clinical symptoms |
| 基金项目: |
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| 中文摘要: |
| 目的 Giligher分级是目前应用最广泛的痔病严重度评分系统，但其缺乏对脱垂以外临床症状和生命质量的评估，本研究拟从生命质量评价和临床症状的角度探讨 Goligher分级评价痔病严重程度的性能。方法对 2017年 5月至 2018年 9月在北京中医药大学东直门医院肛肠科住院的痔病病人进行人口学和疾病情况调查，予以 Goligher分级，同时应用 SF-36量表评估病人生命质量，统计分析痔病 Goligher各分级之间生命质量和脱垂以外其他症状的差异。结果共 209例痔病病人完成本次调查， Goligher Ⅰ级 74例、 Ⅱ级 27例、 Ⅲ级 42例、 Ⅳ级 66例。 Goligher各分级比较，在 SF-36总分、 PCS和 MCS两个领域以及 PF、RP、GH、VT、SF、RE、MH7个维度方面差异无统计学意义(P>0.05)，BP维度方面差异有统计学意义( P<0.05)；该研究有痔核脱出者 135例，便血 127，肛门疼痛 116例，瘙痒 21例，潮湿感 6例， Goligher各分级比较，在疼痛、便血、肛门潮湿感方面差异无统计学意义( P>0.05)在瘙痒症状方面差异有统计学意义( Z=7.99，P=0.046)；有疼痛症状组和无疼痛症状组比较，在 SF-36总分( Z=.3.73，P<0.001)、P，CS(Z=.3.62，P<0.001)和 MCS(Z=.3.03，P=0.002)两个领域和以及 PF、RP、BP、VT、SF、RE 6个维度方面差异有统计学意义，在 GH和 MH维度方面差异无统计学意义( P>0.05)；有便血症状组和无便血症状组比较，仅 GH(Z= .2.29，P=0.022)和 VT(Z=.2.84，P=0.004)两个维度方面差异有统计学意义；有瘙痒症状组和无瘙痒症状组比较，仅 PF维度( Z = .2.05，P=0.040)方面差异有统计学意义。结论 Goligher分级不能反映痔病病人的生命质量和严重程度，缺少对疼痛和生命质量的评估是影响其评价能力的主要因素。 |
| 英文摘要: |
| Objective Goligher classification is the most widely used hemorrhoid severity score system, but it lacks the evaluationof clinical symptoms and quality of life beyond prolapse. This study aims to explore the ability of Goligher classification to evaluate theseverity of hemorrhoids from the perspective of quality of life and clinical symptoms.Methods The demographic and disease status ofpatients with hemorrhoids in Dongzhimen Hospital, Beijing University of Chinese Medicine from May 2017 to September 2018 were in.vestigated, and Goligher classification was given. SF-36 scale was used to evaluate the quality of life of patients. The differences of qual.ity of life and other symptoms except prolapse among different Goligher classification of hemorrhoids were statistically analyzed.Re. sults A total of 209 patients with hemorrhoids completed the survey, including 74 cases of Goligher classfication I, 27 cases of Goligh.er classification Ⅱ, 42 cases of Goligher classfication Ⅲ and 66 cases of Goligher classification Ⅳ. There was no significant differencein SF-36 total score, PCS and MCS, PF, RP, GH, VT, SF, RE and MH7 dimensions (P>0.05), but there was significant difference in BP dimension (P<0.05). There were 135 cases of prolapse of hemorrhoids, 127 cases of hematochezia, 116 cases of anal pain, 21 cases ofpruritus and 6 cases of dampness. There was no significant difference in pain, hematochezia and anal dampness among Goligher classfi.cation (P>0.05), but there was significant difference in pruritus (Z=7.99, P=0.046). There were significant differences in SF-36 total score (Z=.3.73, P<0.001), PCS (Z=.3.62, P<0.001), MCS (Z=.3.03, P=0.002) and PF, RP, BP, VT, SF and RE between patients withand without pain, but there were no significant differences in GH and MH (P>0.05). Only GH (Z=.2.29, P=0.022) and VT (Z=.2.84, P =0.004) were significantly different between patients with and without hematochezia. There was only significant difference in PF dimen.sion (Z=.2.05, P=0.040) between pruritus and non pruritus.Conclusion Goligher classification can not reflect the quality of life andseverity of hemorrhoids patients. Lack of assessment of pain and quality of life is the main factor affecting the evaluation ability. |
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