腹腔镜手术与开腹手术治疗宫颈癌的疗效及对患者负性情绪、生活质量的影响

Effect of laparoscopic surgery and laparotomy in treating cervical cancer patients and their influence on patients’ negative emotion and quality of life

目的比较腹腔镜手术与开腹手术治疗宫颈癌的疗效及对患者负性情绪、生活质量的影响。方法依据手术方式的不同将100例宫颈癌患者分为观察组(n=61,接受腹腔镜宫颈癌根治术治疗)和对照组(n=39,接受传统开腹手术治疗)。比较两组一般手术指标、负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、生活质量[癌症治疗功能评价系统宫颈癌特异模块(FACT-CX)]和预后情况(生存率、复发率)。结果观察组患者手术时间明显长于对照组(P﹤0.01),术中出血量明显少于对照组(P﹤0.01),术后排气时间和术后住院时间均明显短于对照组(P﹤0.01),淋巴结清扫数明显多于对照组(P﹤0.01)。手术后,两组患者SAS、SDS评分均明显低于本组手术前(P﹤0.01),且观察组患者SAS、SDS评分均明显低于对照组患者(P﹤0.01)。手术后,观察组患者FACT-CX评分高于本组手术前(P﹤0.05),对照组患者FACT-CX评分低于本组手术前(P﹤0.05),且观察组患者FACT-CX评分高于对照组(P﹤0.05)。随访第1、2、3年,两组患者生存率和复发率均无明显差异(P﹥0.05)。结论与传统开腹手术相比,腹腔镜宫颈癌根治术可减少术中出血量,缩短术后排气时间及术后住院时间,增加淋巴结清扫数目,明显改善患者的负性情绪,提高生活质量。

Objective To investigate the effect of laparoscopic surgery and laparotomy in treating cervical cancer and their influence on patients’negative emotion and quality of life.Method A total of 100 patients with cervical can-cer were divided into the observation group(n=61,receiving laparoscopic radical cervical cancer treatment)and the con-trol group(n=39,receiving traditional laparotomy)according to the varying surgical methods.The general surgical indi-cators,negative emotion[self-rating anxiety scale(SAS),self-rating depression scale(SDS)],quality of life[functional assessment of cancer therapy with cervical cancer subscale(FACT-CX)],and prognostic survival(overall survival,recur-rence rate)were compared between the two groups.Result The operation time of the observation group was significant-ly longer than that of the control group(P<0.01),the amount of blood loss during the operation was significantly less than that of the control group(P<0.01),the postoperative exhaust time and postoperative hospital stay of the observation group were significantly shorter than those of the control group(P<0.01),the number of lymph node dissections was sig-nificantly more than that in the control group(P<0.01).After the operation,the scores of SAS and SDS in the two groups were lower than those before the procedure(P<0.01),and the scores of SAS and SDS in the observation group were significantly lower than those in the control group(P<0.01).After the operation,the FACT-CX score of the obser-vation group was higher than that before the operation,the FACT-CX score of the control group was lower than that be-fore the operation(P<0.05),and the FACT-CX score of the observation group was higher than that of the control group(P<0.05).In the first 1,2,and 3 years of follow-up,there was no statistically significant difference in the overall survival and recurrence rate between the two groups of patients(P>0.05).Conclusion Laparoscopic radical cervical cancer could reduce intraoperative bleeding,shorten postoperative exhaust time and postoperative hospital stay,increase the number of lymph node dissections,remarkably improve patients’negative emotions,and improve their life quality com-pared with traditional laparotomy.