腹腔镜下子宫肌瘤剜除术后患者生活质量评估

Assessment of post-operative quality of life of women after LUAO-M

目的了解腹腔镜下双侧子宫动脉阻断联合肌瘤剜除术后患者的生活质量。方法选择行腹腔镜下双侧子宫动脉阻断联合肌瘤剜除术的子宫肌瘤患者198例为研究组；选择行腹腔镜下筋膜内子宫切除术的子宫肌瘤患者207例为对照组。采用世界卫生组织生存质量测定量表简表对两组术前、术后2个月、术后12个月的生活质量进行评估。结果①组内比较：术后2个月，研究组在生理领域评分上较术前显著下降（t=10．13，P〈0．01），心理领域、社会领域评分较术前上升，有统计学意义（t分别为2．51和2．48，均P〈0．05）；术后12个月研究组4个领域及主观感受评分都较术前上升，均有统计学意义（t分别为29．68、5．72、6．11、2．93和14．21，均P〈0．01）。对照组术后2个月生理领域、社会领域评分较术前下降，有统计学意义（t分别为27．90和5．31，均P〈0．01），术后12个月社会领域评分下降，有统计学意义（t=2．18，P〈0．01），生理领域、环境领域评分较术前上升，有统计学意义（t分别为10．03和7．24，均P〈0．01）；②组间比较：术前两组间各领域及主观感受评分差异无统计学意义，术后2个月研究组生理领域、社会领域评分高于对照组，有统计学意义（t分别为17．61和6．00，均P〈0．01）；术后12个月研究组生理领域、心理领域、社会领域以及主观感受评分都高于对照组，均有统计学意义（t分别为9．58、3．11、3．16和8．96，均P〈0．01），环境领域差异不明显（P〉0．05）。结论调查显示研究组的术后生活质量优于对照组。术后生活质量可以作为选择子宫肌瘤治疗方式的一个重要参考指标。

Objective To assess post-operative quality of life of women who underwent laparoscopic uterine artery occlusion combining myomectomy （LUAO-M）. Methods 295 patients with hysteromyoma underwent LUAO-M, of which 198 met the inclusion criteria and agreed to receive follow-up and were included in the study group. 207 patients with hysteromyomas underwent a classical intrafascial supracervical hysterectomy （CISH） and included in the control group. The World Health Organization Quality of Life-BRIEF questionnaire （WHOQOL-BRIEF） was used to assess the quality of life of the patients before surgery and at 2 and 12 months after surgery in each group. Results ① In the study group, at 2 months after surgery, the scores of the patient in physical health domain were decreased significantly as compared with those before the surgery （ t = 10. 13, P 〈 0.01 ）, but the scores of the patient in psychological and social domain were improved and the differences were significant（t =2.51 and 2.48 respectively, both P 〈0.05）. In the control group, the scores of the patient in physical health domain and social relation domain were decreased as compared with those before surgery （ t = 27.90 and 5.31 respectively, beth P 〈 0.01 ）. At 12 months after surgery, the scores of the patient in all domains were significantly improved（t = 29.68, 5.72, 6.11, 2.93 and 14.21 respectively, all P 〈 0.01 ）and the scores of the patient in physical health and environment domain were significantly improved （t = 10.03 and 7.24 respectively,P 〈0.01 ）. ②Between the two groups： before surgery, there were no significant differences in scores in all domains and subjective feeling, at 2 months after surgery, the women in the study group had significantly higher mean scores in physical health domain and social relation domain than the control group （t =17.61 and 6.00 respectively, P 〈 0.01 ）; after 12 months, women in the study group had significantly higher mean scores in physical health, psychological, social relation domains and subjective feeling than the control group （t =9.58, 3.11, 3.16 and 8.96 respectively, all P 〈0.01 ）, but the difference in score in environment domain was no significant. Conclusion The quality of post-operative life of the patients in the study group is better than the control group.