腹腔镜和开腹手术对胃间质瘤患者术后生活质量影响比较的研究

Assessment of quality of life after laparoscopic versus open surgery for gastric stromal tumor patients

目的评估腹腔镜和开腹切除两种手术方式对胃间质瘤患者术后生活质量的影响。方法回顾性调查2011年5月~2016年8月四川大学华西医院接受胃间质瘤切除术(胃部分切除术)的患者。比较腹腔镜与开腹手术患者的基线资料、术后并发症、术后肛门排气时间、术后住院时间、术中出血量和住院费用,使用SF-36生活质量量表评估患者术后生活质量。采用SPSS 19.0软件进行统计分析。结果共纳入89例患者,其中腹腔镜组31例,开腹手术组58例。两组基线资料差异无统计学意义。腹腔镜组的术后肛门排气时间、术后住院时间更短,术中出血量更少,住院总费用更低,两组差异有统计学意义(P<0.05)。但两组在手术时间、术后并发症总发生率等方面,差异无统计学意义(P>0.05)。腹腔镜组和开腹手术组患者SF-36生活质量量表总分分别为737.7±68.3分和665.1±138.1分,腹腔镜组在精力(VT)、社会功能(SF)、精神健康(MH)方面的评分更高,两组差异有统计学意义(P<0.05)。结论腹腔镜治疗胃间质瘤安全有效,比开腹手术创伤更小、患者恢复更快,且患者术后生活质量更好。但受研究设计限制,上述结论还有待更多高质量研究验证。

Objective To compare the quality of life after laparoscopic and open surgery for gastric stromal tumor patients. Methods We collected the data of the patients undergoing the gastric stromal tumor surgery from May 2011 to August 2016 in West China Hospital of Sichuan University, and compared the basic data, complications, micturition time, hospital stay time, bleeding volume and hospitalization expenses. SF-36 scale was used to evaluate the quality of life. Then, SPSS 19.0 software was used for data analysis. Results Eighty nine patients involving 31 laparoscopic patients and 58 open surgery patients were included. There was no statistical significance in basic line between two groups. The laparoscopic group had shorter micturition time and hospital stay time, less intraoperative bleeding and lower hospitalization costs, the differences between two groups were statistically significant （P〈0.05）. But there were no significant differences between two groups in the operation time and postoperative complication rate. The scorces of SF-36 quality of life scale of laparoscopic group and open surgery group were 737.7±68.3 and 665.1 ± 138.1, respectively. The laparoscopic surgery group had higher scores in validity （VT）, social function （SF） and mental health （MH） than those in open surgery group with significant differences （P〈0.05）. Conclusion Laparoscopic surgery is safe and effective for the patients with stromal tumor. Patients in laparoscopic group have shorter recovery time and higher quality of life than open surgery group. Due to the limited of study design, more high quality studies are needed to verify above conclusion.