腹腔镜与开腹手术对早期卵巢恶性肿瘤生存质量影响的比较

The effect of open and laparoscopic surgery on quality of life of patients with early-stage maligmant ovary tumor

摘要:

目的 探讨腹腔镜与开腹手术对老年早期卵巢恶性肿瘤患者术后生活质量的影响。 方法 选择2009年12月～2011年12月该院住院治疗的老年早期卵巢恶性肿瘤患者75例，根据手术方式分为两组：腹腔镜组（40例）和开腹组（35例）。应用GLQI调查表对两组患者进行了术前及术后1周、术后1个月、术后3个月时生存质量的评估。 结果 QLQ-C30调查表结果分析，两组患者的术前整体健康领域、功能领域（躯体功能、角色功能、情绪功能、认知功能及社会功能）、主要症状领域（疲乏、恶心呕吐、疼痛）和6个单项条目（气促、食欲减退、睡眠障碍、便秘、腹泻和经济状况）比较，差异无显著性（P >0.05）。术后1周，两组患者QLQ-C30评价的总体健康情况、功能领域各项目得分均较术前有所下降，但腹腔镜组与术前比较，差异无显著性（P >0.05），而开腹组与术前比较，存在显著差异（P <0.05）。同时两组患者主要症状领域和6个单项条目各项目得分均较术前明显升高（P <0.05）。术后1个月、3个月，两组患者QLQ-C30评价的整体健康领域、功能领域各项目得分均逐渐上升，主要症状领域和6个单项条目各项目得分均逐渐下降，腹腔镜组术后3个月时与术前水平比较，差异有显著性（P <0.05），而开腹组术后3个月时基本恢复术前水平。组间比较，腹腔镜组患者QLQ-C30评价的整体健康领域、功能领域各项目得分均明显高于开腹组患者，主要症状领域和6个单项条目各项目得分明显低于开腹组。 结论 与开腹手术比较，腹腔镜手术能更显著地改善老年早期卵巢恶性肿瘤患者术后的生存质量。

Abstract:

【Objective】 To investigate the effect of open and laparoscopic surgery on quality of life of patients with early-stage maligmant ovary tumor. 【Methods】 75 cases with early-stage maligmant ovary tumor were divided into two groups: LAP group (40 cases) were given laparoscopic surgery, OP group (35 cases) were given open surgery. Quality of life questionnaire-core 30 (QLQ-C30) of two groups were compared before operation and at 1 week, 1, 3 month after operation. 【Results】 There were no difference in QLQ-C30 before operation between two groups (P >0.05). One week after operation, the functioning scales and overall health of QLQ-C30 in two group decreased, symptom and single field (tired, pain, anhelation, ahypnosis, economic difficulties) of QLQ-C30 in two group increased. But there were no difference in LAP group one week after operation compared with before operation (P >0.05) and there were significantly difference in OP group one week after operation compared with before operation (P <0.05). At 1, 3 month after operation, the functioning scales and overall health of QLQ-C30 in two group increased gradually, symptom and single field (tired, pain, anhelation, ahypnosis, economic difficulties) of QLQ-C30 in two group decreased gradually. There were significantly difference in LAP group 3 month after operation compared with before operation (P >0.05) and there were no difference in OP group (P <0.05). At 1 week, 1, 3 month after operation, the functioning scales and overall health of QLQ-C30 in LAP group were higher than those in OP group (P <0.05) and symptom and single field of QLQ-C30 in LAP group were lower than those in OP group (P <0.05). 【Conclusion】 Laparoscopic for patients with early-stage maligmant ovary tumor has a higher quality of life. It is better than open surgery.