腹腔镜与开腹胃癌根治术后患者生存质量分析

Quality of life after laparoscopic and open radical resection for gastric cancer

目的调查胃癌根治术后患者生存质量变化情况,研究原发胃癌根治术后患者生存质量的影响因素。方法采用消化病生存质量指数(GLQI)测定45例原发胃癌根治术后患者的生存质量,分析其影响因素并比较腔镜手术与开腹手术生存质量的不同。结果患者术后GLQI评分与患者年龄无相关性。随病理分期增高,患者GLQI总分、心理情绪状态、生理功能状态及主观症状评分显著降低(P<0.05),而社会活动状态评分无显著变化(P>0.05)。男性患者在GLQI总分及生理功能状态上均优于女性患者(P<0.05),而在心理情绪状态、社会活动状态及主观症状评分无明显差异(P>0.05)。手术后2周腹腔镜组在GLQI总分、生理功能状态及主观症状方面优于开腹组(P<0.05),而在心理情绪状态及社会活动状态评分无明显差异(P>0.05)。手术3个月以后,腹腔镜组在GLQI总分及主观症状优于开腹组(P<0.05),而在心理情绪状态、生理功能状态及社会活动状态评分无显著性差异(P>0.05)。结论胃癌根治术后患者的肿瘤病理分期、性别及手术方式是患者术后生存质量的影响因素,其中病理分期早优于分期晚的患者,男性优于女性,腹腔镜手术优于开腹手术。

Objective To investigate life quality of the patients after radical resection for gastric cancer,and analyze its influencing factors.Methods The Gastrointestinal Life Quality Index(GLQI) was used to assess quality of life in 45 patients who underwent radical resection for gastric cancer.Quality of life was compared between laparoscopic and open gastrectomy groups,and its influencing factors were investigated.Results The patients' age was not correlated with GLQI scores and other partial parameters of the life quality index such as emotional status,physical functions,social activities and subjective symptoms.With more later clinical stages,GLQI scores,emotional status,physical functions and subjective symptoms except social activities got more worse(P<0.05).The GLQI scores and physical functions in the male patients were better than those in the female patients(P<0.05),but there were no differences in emotional status,social activities and subjective symptoms between them.Two weeks after operation,the GLQI scores,physical functions and subjective symptoms in laparoscopic group were significantly better than those in open resection group(P<0.05),but there were no differences in emotional status and social activities between the two groups.Three months after operation,the GLQI scores and subjective symptoms in laparoscopic group were significantly better than those in open group(P<0.05),but there were no differences in emotional status,physical functions and social activities between the two groups.Conclusions Different tumor stages,sex and surgical procedures are correlated with quality of life in the patients after radical resection for gastric cancer.Quality of life is better in male patients or those with early TNM stage and laparoscopic gastrectomy than those respectively in female patients or those with late TNM stage and open gastrectomy.