腹腔镜手术治疗老年妇科恶性肿瘤的临床疗效及对患者术后生活质量的影响

Effect of laparoscopic surgery in treatment of elderly gynecologic malignancies and its effect on postoperative quality of life

目的:探讨腹腔镜手术治疗老年妇科恶性肿瘤的临床疗效及对患者术后生活质量的影响。方法:选择某院接受治疗的老年妇科恶性肿瘤患者146例为观察对象,采用随机数字表法将患者分为2组,每组各73例。2组患者均对术前并发症进行评估与干预,对照组患者行传统开腹手术,对子宫内膜癌及宫颈癌的患者均行广泛全子宫切除术加盆腔淋巴结清扫术(A术式),对卵巢癌的患者行大网膜、阑尾、全子宫、双附件切除术及盆腔和腹主动脉淋巴结清扫术(B术式)。观察组患者行腹腔镜下手术,切除范围同对照组。对2组患者手术一般情况、并发症发生率、1年存活率及生活质量进行比较。结果:2种术式下对照组术中出血量、肛门排气时间、术后住院时间均大于观察组(P<0.05);对照组手术时间较观察组短(P<0.05);2组患者并发症发生率、1年生存率比较,差异无统计学意义(P>0.05);2组患者生活质量量表得分均呈先下降后升高的趋势,观察组在各时间点生活质量量表得分均明显高于对照组(P<0.05)。结论:腹腔镜手术治疗老年妇科恶性肿瘤疗效确切,可明显减少术中出血量,缩短肛门排气时间及住院时间,提高患者生活质量。

Objective： To investigate the clinical efficacy of laparoscopic surgery for the treatment of elderly gynecologic malignan- cies and its influence on postoperative quality of life. Methods ： A total of 146 elderly patients with gynecological malignant tumors were selected and randomly divided into two groups ,73 cases in each group. The two groups of patients were assessed and intervened in terms of preoperative complications so as to meet the requirement of the operation. The control group was treated with traditional laparotomy while the patients in the obseraration group underwent laparoscopic surgely. The resection scope was the same for both the control group and the observation group. The two groups of patients were compared in terms of general surgely conditions, complications, 1-year survival rate and quality of liie. Results：The intraoperative blood loss, anal exhaust time and postoperative hospital stay in the control group were significantly inierior to those in the observation group （ P 〈 0.05 ）. However, the operation time of the control group was sig- nificantly shorter than that of the observation group （ P 〈 0.05 ）. There was no significant difference in terms of the incidence of compli- cations and 1 -year survival rate between the two groups （ P 〉 0.05 ）. The QOL scores of both groups showed a trend of first decreasing and then increasing, and the scores of quality of life in the observation group at each time point were significantly higher than those in the control group（ P 〈 0.05 ）. Conclusion：Laparoscopic surgely for the treatment of elderly gynecological malignancies is effective and can significantly reduce the amount of bleeding during surgely. It can shorten the time of anal exhaust, reduce the length of hospital stay, and improve the quality of life of patients.