腹腔镜胆囊切除治疗对胆结石患者GLQI评分的影响分析

Effect of Laparoscopic Cholecystectomy on GLQI Scores in Patients with Gallstones

目的研究对患有胆结石的患者经腹腔镜行胆囊切除术治疗后,患者的GLQI评分的变化情况,评估腹腔镜胆囊切除术对患者GLQI评分的影响。方法选取2015年6月—2017年6月于该院普外科就诊确诊为胆结石并于该院治疗的78例患者为研究对象。按单纯随机抽样方法将研究对象分为实验组和对照组,其中实验组41例,对照组37例。其中实验组采用腹腔镜胆囊切除术予以治疗,对照组采取传统开腹方式予以胆囊切除治疗。分析两组患者的手术时长、术后疼痛、术后肠蠕动恢复时间、住院天数,以及患者术后1个月、半年、1年的消化病生存质量指数(Gastro-intestinal quality of life index,GLQI)。结果实验组手术用时(56.13±10.07)min少于对照组(94.52±12.36)min,差异有统计学意义(t=15.099,P=0.000);实验组VAS评分(7.58±2.31)分小于对照组(9.15±1.04)分,说明实验组患者的疼痛程度较对照组轻,差异有统计学意义(t=3.933,P=0.000);实验组肠蠕动恢复时间(24.11±3.21)d少于对照组(39.86±3.40)h,差异有统计学意义(t=21.992,P=0.000);实验组患者的住院天数(6.25±0.93)少于对照组(9.87±1.12)d,差异有统计学意义(t=15.584,P=0.000)。实验组在术后半年GLQI评分均比术后1个月得分高(t=5.036,P=0.000),、术后1年的GLQI评分比术后1个月得分高(t=8.860,P=0.000),且术后1年的得分高于术后半年(t=3.215,P=0.002),差异有统计学意义。对照组组在术后半年GLQI评分均比术后1个月得分高(t=2.720,P=0.008),、术后1年的GLQI评分比术后1个月得分高(t=4.745,P=0.000),且术后1年的得分高于术后半年(t=2.437,P=0.017),差异有统计学意义。实验组在术后半年GLQI评分均高于对照组(t=2.294,P=0.025),实验组在术后1年GLQI评分均高于对照组(t=1.992,P=0.001),差异有统计学意义。结论对患有胆结石者的治疗,选取腹腔镜下胆囊切除术治疗GLQI评分高于开腹手术治疗,患者的术后恢复更好,更能改善患者的生存质量。

Objective This paper tries to investigate the changes of GLQI scores after laparoscopic cholecystectomy in patients with gallstones, and to evaluate the effect of laparoscopic cholecystectomy on GLQI scores. Methods A total of 78 patients diagnosed with gallstones and treated in this hospital from June 2015 to June 2017 in our general surgery department were selected as study subjects.According to a simple random sampling method, the subjects were divided into experimental group and control group, 41 in the experimental group and 37 in the control group. The experimental group was treated with laparoscopic cholecystectomy. The control group was treated with traditional laparotomy for cholecystectomy. The length of operation, postoperative pain, postoperative recovery of bowel movements, days of hospitalization, and the patient＇s postoperative 1 st, 6 th, and 1 st years of digestive quality of life index（GLQI） were analyzed. Results In the experimental group, the operation time（56.13±10.07）min was less than the control group（94.52±12.36）min, the difference was statistically significant（t=15.099, P=0.000）; the VAS score of the experimental group（7.58±2.31）points was lower than that of the control group（9.15 ±1.04）points, indicating that the degree of pain in the experimental group was lighter than that in the control group, with significant differences（t=3.933, P=0.000）; the recovery time of intestinal peristalsis in the experimental group（24.11±3.21）h was less than the control group（39.86 ±3.40）h, the difference was statistically significant（t = 21.992, P =0.000）; the length of hospital stay in patients in the experimental group（6.25 ± 0.93）d was less than the control group（9.87 ± 1.12）d,and the difference was statistically significant（ t=15.584, P=0.000）. In the experimental group, the GLQI scores were higher than those in the first postoperative month（t=5.036, P=0.000） and the GLQI scores were higher in the first postoperative year than in the postoperative month（t=8.860, P=0.000）, and the score after one year was higher than after six months（t=3.215, P=0.002）, and the difference was statistically significant. In the control group, the GLQI scores were higher than those in the first postoperative month（t =2.720, P=0.008）. The postoperative GLQI score was higher than the postoperative one month score（t=4.745, P=0.000）, and the score after 1 year was higher than that after 6 months（t=2.437, P=0.017）. The difference was statistically significant. The GLQI scores in the experimental group were higher than those in the control group（t=2.294, P=0.025） in the first half of the postoperative period, and the GLQI scores in the experimental group were significantly higher than those in the control group（t=1.992, P=0.001） at 1 year after surgery. The difference was significant. Conclusion For the treatment of patients with gallstones, laparoscopic cholecystectomy for the treatment of GLQI score is higher than open surgery, the patient＇s postoperative recovery is better, and can improve the patient＇s quality of life.