안와감압술이 갑상선안병증 환자의 삶의 질에 미치는 영향
Change in Quality of Life after Orbital Decompression Surgery in Patients with Dysthyroid Ophthalmopathy
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목적: 갑상선안병증 환자에서 안와감압술 수술 후의 환자의 삶의 질 변화를 조사하였다. 대상과 방법: 2014년 8월부터 2015년 12월까지 본원에 내원하여 갑상선안병증으로 진단 받고 수술을 받은 30명과 경과관찰만을 한 50명을 대상으로 의무기록을 분석하였다. 환자들은 수술 전후에 Grave’s ophthalmopathy specific quality of life (GO-QoL) 설문지를 작성하였다. 설문 조사 결과를 비교하고 이에 영향을 줄 수 있는 나이, 유병기간, 안구돌출도 등의 인자들을 조사하였다. 결과: 안와감압술을 받은 환자들(28.8 ± 17.1점)은 경과 관찰만 하는 환자들(42.7 ± 21.1점)에 비해 수술 전 더 낮은 외모 관련 삶의 질 점수를 보였다(p<0.001). 안와감압술 후에, 외모 관련 삶의 질 점수는 28.8 ± 17.1점에서 51.5 ± 18.8로 증가했다(p=0.024). 시각 관련 삶의 질 점수는 안와감압술을 받은 환자와 받지 않은 환자에서 차이가 없었다. 안와감압술 시행 전과 후를 비교한 결과에서도 시각 관련 삶의 질 점수는 유의한 차이는 보이지 않았다. 술 후의 환자의 시각 관련 삶의 질 점수의 향상 정도는 술 후 환자의 안구돌출도와 유의한 상관관계를 보였다. 결론: 안와감압술은 외모와 관련된 삶의 질 점수를 증가시켰다. 심리적 접근 또한 환자의 삶의 질을 높이는 데 필요하겠다.
Abstract
Purpose: To evaluate the effect of orbital decompression surgery on quality of life in thyroid-associated ophthalmopathy (TAO) patients. Methods: From August 2014 to December 2015, 80 patients diagnosed with TAO at our clinic were retrospectively analyzed. The patients were divided into 2 groups: 30 patients who underwent orbital decompression surgery and 50 patients who did not receive surgery. The Korean version of the Grave’s ophthalmopathy specific quality of life (GO-QoL) questionnaire was completed by all patients. We compared questionnaire scores between groups and analyzed demographic and clinical factors affecting change in GO-QoL. Results: The patients who underwent orbital decompression had lower mean GO-QoL score for appearance in comparison with patients without orbital decompression (p < 0.001). The mean GO-QoL score for appearance was increased from 28.8 ± 17.1 to 51.5 ± 18.8 after orbital decompression (p = 0.024). The mean GO-QoL score for visual function was not different between the patients who did not receive surgery and the orbital decompression group. The mean GO-QoL score for visual function was not changed after orbital decompression. There was a significant relation between postoperative proptosis degree and change in GO-QoL score for appearance after orbital decompression. Conclusions: GO-QoL score for appearance was significantly improved after orbital decompression surgery, and psychological interventions should be considered to enhance the quality of life outcomes.
참고문헌 (18)
- Burch HB., "Graves' ophthalmopathy : current concepts regarding pathogenesis and management", Endocr Rev, 14, pp.747~793 (1993)
- Bahn RS., "Understanding the immunology of Graves' ophthalmopathy. Is it an autoimmune disease?", Endocrinol Metab Clin North Am, 29, pp.287, vi~296, vi (2000)
- Choi YJ., "Assessing Graves' ophthalmopathy-specific quality of life in Korean patients", Eye(Lond), 26, pp.544~551 (2012)
- Son BJ., "Evaluation of thyroid eye disease : quality-of-life questionnaire(TED-QOL)in Korean patients", Can J Ophthalmol, 49, pp.167~173 (2014)
- Hun Lee, "Assessment of Quality of Life and Depression in Korean Patients with Graves’ Ophthalmopathy", Korean Journal of Ophthalmology, 24(2), pp.65~72 (2010), 대한안과학회
- Bartalena L., "Glucocorticoid therapy of Graves' ophthalmopathy", Exp Clin Endocrinol, 97, pp.320~327 (1991)
- Lyons CJ., "Orbital decompression for disfiguring exophthalmos in thyroid orbitopathy", Ophthalmology, 101, pp.223~230 (1994)
- Fatourechi V., "Graves ophthalmopathy. Results of transantral orbital decompression performed primarily for cosmetic indications", Ophthalmology, 101, pp.938~942 (1994)
- Wickwar S., "The psychosocial and clinical outcomes of orbital decompression surgery for thyroid eye disease and predictors of change in quality of life", Ophthalmology, 122, pp.2568.e1~2576.e1 (2015)
- Terwee CB., "Interpretation and validity of changes in scores on the Graves' ophthalmopathy quality of life questionnaire(GO-QOL)after different treatments", Clin Endocrinol(Oxf), 54, pp.391~398 (2001)
- Mourits MP., "Clinical activity score as a guide in the management of patients with Graves' ophthalmopathy", Clin Endocrinol(Oxf), 47, pp.9~14 (1997)
- Terwee CB., "Test-retest reliability of the GO-QOL : a disease-specific quality of life questionnaire for patients with Graves' ophthalmopathy", J Clin Epidemiol, 52, pp.875~884 (1999)
- Achtsidis V., "Dry eye in Graves ophthalmopathy : correlation with corneal hypoesthesia", Eur J Ophthalmol, 23, pp.473~479 (2013)
- Abràmoff MD., "Rectus extraocular muscle paths and decompression surgery for Graves orbitopathy : mechanism of motility disturbances", Invest Ophthalmol Vis Sci, 43, pp.300~307 (2002)
- Garrity JA., "Results of transantral orbital decompression in 428 patients with severe Graves' ophthalmopathy", Am J Ophthalmol, 116, pp.533~547 (1993)
- Terwee CB., "Development of a disease specific quality of life questionnaire for patients with Graves' ophthalmopathy : the GO-QOL", Br J Ophthalmol, 82, pp.773~779 (1998)
- Soeters MR., "Optimal management of Graves orbitopathy : a multidisciplinary approach", Neth J Med, 69, pp.302~308 (2011)
- Carr T., "The DAS24: a short form of the Derriford Appearance Scale DAS59 to measure individual responses to living with problems of appearance", Br J Health Psychol, 10(Pt2), pp.285~298 (2005)