腹腔镜与开腹结肠癌根治手术对 患者术后近期生命质量的影响

Effect of open and laparoscopic surgery on quality of life of patients with colon cancer

摘要:

目的 对腹腔镜与开腹手术后结肠癌患者生存质量进行评估，并比较腹腔镜与开腹手术对患者生存质量的影响。方法 收集该院普外科收治的结肠癌患者125例，将其根据手术方式不同分组：腹腔镜组65例和开腹组60例，应用GLQI调查表对两组患者进行了术前及手术后1个月内生存质量的评估。结果 术前生存质量调查显示两组患者的总体生存质量和各子项目无明显差异（P >0.05），均明显低于正常人。术后1 d，腹腔镜组患者的GLQI总分、主观症状、躯体生理功能状态、社会活动状态、心理情绪状态项目得分均较术前有所下降，但差异无显著性（P >0.05）；术后3 d起，GLQI总分和各项目得分均逐渐上升，术后30 d时，已经明显高于术前水平（P <0.05），已达到或接近正常人水平。术后1 d，开腹组患者的GLQI总分、主观症状、躯体生理功能状态、社会活动状态、心理情绪状态项目得分均较术前明显下降（P <0.05），术后3 d起，GLQI总分和各项目得分有所回升，但仍明显低于术前水平（P <0.05），至30 d时基本恢复术前水平。组间比较，术后1、3、7、14及30 d腹腔镜组患者GLQI总分、主观症状、躯体生理功能状态、社会活动状态、心理情绪状态项目得分均明显高于对照组患者（P <0.05）。结论 针对结肠癌患者，腹腔镜结肠根治术不仅可取得满意的临床疗效，更能显著改善患者术后的生活质量，明显优于开腹手术。

Abstract:

【Objective】 To investigate the effect of open and laparoscopic surgery on quality of life of patients with colon cancer. 【Methods】 Author retrospectively analyzed the 125 cases with colon cancer treated in department of general surgery, who were divided into two groups: LAP group(65 cases) was given laparoscopic treatment, OP group (60 cases) was given open surgery treatment. Gastrointestinal quality of life index(GQLI) of laparoscopic colectomy and open lobectomy were compared before operation and in 1 month after operation. 【Results】 There was no difference before operation between two groups(P >0.05), and GQLI were lower in two groups than those of the normal old people (P <0.05). At one day after operation, the level of GQLI, the functioning scales of physical, rational symptom，role, cognitive, and social function in LAP group decreased, but no difference compared with before operation (P >0.05). At 3 days after operation, the level of GQLI and the functioning scales in LAP group increased gradually and at 30 days after operation, the level of GQLI and the functioning scales in LAP group were higher thanthose before operation (P <0.05). At one day after operation, the level of GQLI, the functioning scales of physical, rational symptom, role, cognitive, and social function in OP group decreased significantly (P <0.05). At 3 days after operation, the level of GQLI and the functioning scales in OP group increased gradually, but were lower than those before operation (P <0.05).At 30 days after operation, the level of GQLI and the functioning scales in op group were no difference compared with before operation (P >0.05). At 1,3,7,14,30 day after operation, the level of GQLI, the functioning scales of physical, rational symptom，role，cognitive，and social function in LAP group were higher than those in OP group(P <0.05). 【Conclusions】 Laparoscopic treatment for colon cancer patients has better effect and a higher GQLI, is better than that of open surgery treatment.