粘连性肠梗阻经腹腔镜手术治疗的效果及对生存质量、睡眠状况自评量表的影响

Clinical efficacy and effects on quality of life and self-rating scale of sleep laparoscopic surgery in the treatment of adhesive intestinal obstruction

目的探讨经腹腔镜手术治疗粘连性肠梗阻的临床效果,并分析对生存质量、睡眠状况自评量表(SRSS)的影响。方法选取我院2014年6月~2016年6月收治的62例粘连性肠梗阻患者,按入院时间顺序进行编号,采用随机数字表法分为两组,观察组31例,采用腹腔镜手术,对照组31例,采用常规开腹手术治疗。记录两组患者术后切口感染、肠瘘、尿路感染、复发等并发症发生率,比较两组患者术后生存质量、SRSS情况。结果观察组总并发症发生率为3.2%,复发率为0,均显著低于对照组(25.8%,12.9%),差异有统计学意义(P<0.05);观察组术后所处环境状态[(78.4±5.6)分],社交能力[(71.3±5.8)分],生理功能[(67.5±5.7)分],心理能力[(78.4±5.4)分],均较对照组高[(65.1±5.4)、(61.8±5.6)、(57.2±4.3)、(66.1±5.9)分],差异有统计学意义(P<0.05);观察组术后SRSS评分中各项均低于对照组,差异有统计学意义(P<0.05)。结论经腹腔镜下治疗粘连性肠梗阻疗效显著,可提高患者生存质量、改善睡眠状况。

Objective To discuss the clinical efficacy of laparoscopic surgery in the treatment of adhesive intestinal obstruction, and analysis the effect on quality of life and self-rating scale of sleep.Methods A total of 62 patients with adhesive intestinal obstruction in our hospital from June 2014 to June 2016,which were numbered based on the time of admission, were randomly classified into two groups according to random number table,with observation group （n=31） treated with laparoscopic surgery,and control group （n=31） treated with laparotomy.Then the incidences of incision infection, intestinal fistula,urinary tract infection and recurrence were compared, and quality of life and self-rating scale of sleepstatus were analyzed.Results The recurrence rate（O） and total complications incidence rate（3.2%） in observation group were markedly lower then those in control group（12.9%,25.8%）（P〈0.05）;the environmental status[（78.4±5.6）scores], social acceptability[（71.3±5.8）scores], physiological function[（67.5±5.7）scores], mental ability[（78.4±5.4）scores] of the observation group, were remarkably higher then those in control group [（65.1±5.4）, （61.8±5.6）, （57.2±4.3）,（66.1±5.9）scores] （P〈0.05）;the score of each item of SRSS in observation group were statistically lower then those in control group, （P〈0.05）o Conclusion The laparoscopic surgery has significant clinical effect in the treatment of adhesive intestinal obstruction, and can improve quality of life and sleep status.