腹腔镜与小切口胆囊切除术后患者生存质量比较

Laparoscopic versus mini cholecystectomy: Analysis of postoperative quality of life

目的比较腹腔镜胆囊切除术(laparoscopiccholecystectomy,LC)与小切口胆囊切除术(mini-incisioncholecystectomy,MC)后患者生存质量的差异。方法对152例胆囊切除术后患者生存质量进行调查,其中LC组78例,MC组74例,利用美国36项健康观察概况表(SF-36)对2组患者进行评估。结果调查问卷的随访时间LC组为(24·2±3·1)周,MC组为(23·9±2·9)周。LC组和MC组术前SF-36总分平均109·3分和107·2分(t=1·571,P=0·118)。LC组术后2周时,SF-36总分为107分,下降不明显(P>0·05),术后4周以后SF-36总分、主观症状、生理功能、社会活动及心理情绪等方面均显著高于术前水平(P<0·05)。MC组术后2周时SF-36总分为100分,降幅明显(P<0·05),同时主观症状、生理功能、社会活动及心理情绪等方面分值均较术前明显下降(P<0·05),术后4周时SF-36总分为106分,恢复至术前水平(P>0·05),术后8周以后,SF-36总分、主观症状、生理功能、社会活动及心理情绪等方面均显著高于术前水平(P<0·05)。术后8周内LC组SF-36总分显著高于MC组(P<0·05)。结论LC组术后生存质量优于MC组。

Objective Tolaparoscopic or mini cholecystectomyinvestigate the postoperative quality of life （QOL） in two groups of patients treated with Methods The quality of life was evaluated in 152 patients after either laparoscopic cholecystectomy （Group LC, 78 patients） or mini cholecystectomy （Group MC, 74 patients） by using the Medical Outcomes Study 36 - Item Short - Form Health Survey （ SF - 36）. Results The length of follow - up was （24. 2 ＋ 3. 1 ） weeks in the Group LC and （23.9 ＋2. 9） weeks in the Group MC. The mean preoperative SF- 36 scores of all dimensions of the quality life were 109 in the Group LC and 107 in the Group MC respectively （t = 1. 571 ,P =0. 118）. In the Group LC, the SF -36 score decreased insignificantly at 2 weeks after operation （ 107, P 〉 0. 05 ）, whereas a significant improvement in SF - 36 score, symptomatology, and emotional and physiological status was noted at 4 weeks after operation （ P 〈 0.05 ）. In the Group MC, the SF - 36 score was 100 after 2 weeks （ P 〈0. 05） with a significant drop in the aspects of symptomatology, physiological and social status （ P 〈 0. 05 ） and the SF - 36 score reached to the preoperative level of 106 after 4 weeks （P 〉 0. 05）. The SF - 36 score, symptomatology, and physiological and social status of the Group MC were significantly improved 8 weeks after operation than preoperation （P 〈 0. 05）. The Group LC showed a remarkably better SF - 36 score than the Group MC for up to 8 weeks postoperatively （ P 〈 0. 05 ）. Conclusions The quality of life after LC is superior to that after MC.