食管、贲门癌切除食管胃分层吻合术患者生命质量评价

Quality of life scores for esophageal and cardiac carcinoma after delaminated esophagogastrostomy

目的 探讨食管、贲门癌切除食管胃分层吻合术的手术效果 ,评价患者手术后生命质量。 方法 根据手术方式不同将 2 6 4例食管、贲门癌患者分为两组 ,食管胃分层吻合组 :16 2例 ,行食管、贲门癌切除 ,食管胃黏膜连续缝合 ,食管胃分层吻合术 ;器械吻合组 :10 2例 ,行食管、贲门癌切除 ,食管胃吻合器吻合术。均用欧洲癌症研究与治疗组织(EORTC) QL Q- C30和自制量表对患者术后 3～ 6个月生命质量进行测评 ,并进行比较。 结果 食管胃分层吻合组有137份问卷、器械吻合组有 77份问卷符合评分要求。食管胃分层吻合组在体力功能和情感功能维度得分高于器械吻合组 (P<0 .0 5 ) ,吞咽困难维度、胃食管反流症状维度得分低于器械吻合组 (P<0 .0 5 ) ,其他维度两组比较差别无显著性意义 (P>0 .0 5 )。 结论 食管胃分层吻合术后患者体力功能和情感功能优于器械吻合术 ,吞咽困难、反流症状少于器械吻合术 ,生命质量高于器械吻合术。

Objective To explore the surgical results of the patients with esophageal and cardiac carcinoma after delaminated esophagogastrostomy and evaluate their quality of life. Methods Two hundred and sixty-four patients were divided into two groups, 162 patients with esophageal and cardiac carcinoma were resected with delaminated esophagogastrostomy (delaminated esophagogastrostomy group) and 102 patients were resected with stapled anastomosis (stapled anastomosis group). Quality of life was questioned with European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and self-made questionnaire. Results One hundred thirty-seven patients in delaminated esophagogastrostomy group and 77 patients in stapled anastomosis group questionnaires were coincided with demands. The scores of physical function and emotional function in delaminated esophagogastrostomy group were higher than those in stapled anastomosis group( P <0.05), scores of dysphagia symptom and reflux symptom were lower than those in stapled anastomosis group( P <0.05), but there was no significance in other scores ( P >0 05). Conclusions The physical function and emotional function in patients with delaminated esophagogastrostomy were better than those in stapled anastomosis, dysphagia symptom and reflux symptom were less than those in stapled anastomosis, and the quality of life were better than those in stapled anastomosis group.