臨牀消化器内科 Vol.24 No.11(2-5)


特集名 胃切除後の諸問題
題名 胃切除後障害 ( 5 ) 胃切除後の機能障害とQOLの評価 -- 現状と展望
発刊年月 2009年 10月
著者 中村 美鈴 自治医科大学看護学部成人看護学
著者 細谷 好則 自治医科大学医学部消化器外科
著者 段ノ上 秀雄 自治医科大学看護学部成人看護学
著者 武正 泰子 自治医科大学看護学部成人看護学
著者 矢野 雅彦 大阪府立成人病センター消化器外科
著者 土岐 祐一郎 大阪大学大学院医学系研究科消化器外科
【 要旨 】 胃切除後は,消化管の切除や再建により,さまざまな機能障害に伴う身体症状を生じ,結果としてQOLは低下する.根治性を損なうことなく機能温存を目指した手術は重要である.しかし,胃切除後に限定した機能障害やQOLを客観的に評価する方法はきわめて少ないため,術式の比較検討が困難な状況にある.本稿では,胃切除後の諸症状と具体的な生活上の困難について述べ,胃切除後の機能障害とQOLの評価に関する現状と問題点について述べる.さらにわれわれが開発した上部消化管癌の術後機能評価法の尺度(DAUGS-32;DysfunctionAfterUpperGastrointestinal Surgery-32)と今後の展望について報告する.
Theme Clinical Problems after Gastrectomy
Title Postgastrectomy Dysfunction and Evaluation of QOL : Present State and Future Development
Author Misuzu Nakamura School of Nursing, Department of Surgery, Jichi Medical University
Author Yoshinori Hosoya Department of Surgery, Jichi Medical University
Author Hideo Dannoue School of Nursing, Department of Surgery, Jichi Medical University
Author Yasuko Takemasa School of Nursing, Department of Surgery, Jichi Medical University
Author Masahiko Yano Department of Surgery, Osaka Medical Centerf or Cancer and Cardiovascular Diseases
Author Yuichiro Doki Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine
[ Summary ] After gastrectomy, resection or reconstruction of the digestive tract results in various dysfunction-related physical symptoms. However, few studies have evaluated the severity of various physical symptoms related to postgastrectomy dysfunction. These symptoms affectpatients' daily lives after gastrectomies, markedly reducing their quality of life (QOL). Therefore, radical surgery aimed at preserving function is emphasized. In this article, we review various symptoms following gastrectomy and serious difficulties experienced by patients in their daily lives. We also describe trends in studies regarding the assessment of postgastrectomy dysfunction and QOL. Furthermore, we investigate which type of scale is appropriate to evaluate these conditions. In addition, we discuss the development and future application of our method for functional assessment after surgery for upper digestive tract cancer.
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