·临床研究·

不同手术方式对结直肠癌患者生命质量的影响

吴晓琴夏海鸥章灵君孔振芳张晓菊

摘要目的：探讨传统腹部手术与腹腔镜结直肠癌根治术对患者术后生命质量的不同影响。方法：选取某三甲医院肛肠科2013年12月～2014年3月行结直肠癌根治术患者51例，其中传统开腹手术27例，腹腔镜手术24例，在术后3个月采用肠癌患者生命质量测定量表QLICP-CR进行生命质量调查，比较两种手术方式患者术后3个月生命质量。结果： 腹腔镜手术组患者术后3个月整体生命质量、躯体功能领域和共性症状与副作用的标准化得分明显比传统腹部手术高，躯体功能中的基本生理功能比传统腹部手术高，化疗期间副反应比传统手术组少，差异有统计学意义(P<0.05)。腹腔镜手术组在心理功能领域的情绪得分明显比传统腹部手术组高，差异有统计学意义(P<0.05)。结论：腹腔镜手术后的结直肠癌患者生命质量比传统手术高，主要体现在基本生理功能好、情绪稳定和短期内化疗副反应较轻3个方面。临床医护人员需根据不同术式的结直肠癌患者具体情况，有针对性地提供干预措施来提高患者生命质量。

关键词结直肠癌；腹腔镜；开腹；生命质量doi:10.3969/j.issn.1672-9676.2015.08.002

Effect of different operative way on quality of life in patients with colorectal cancer

WU Xiao-qin,XIA Hai-ou(Nursing College of Fudan University,Shanghai200032)

ZHANG Ling-jun(Lihuili Hospital of Ningbo Medical Center)//KONG Zhen-fang(Ningbo Second Hospital)//et al

AbstractObjective:To explore the traditional abdominal surgery and laparoscopic colorectal cancer radical different impact on the life quality of postoperative patients.Methods:51 patients with colorectal cancer radical from December 2013 to March 2014 were selected,27 cases with traditional laparotomy,laparoscopic surgery 24 cases.3 months after surgery with colon cancer patients quality of life measurement scale QLICP-CR to investigate quality of life.To compare two kinds of operation method 3 months postoperatively in patients with quality of life.Results:3 months postoperatively in patients with laparoscopic surgery group overall quality of life,physical function and common symptoms and side effects in the field of standardization scored significantly higher than traditional abdominal surgery,the basic physiological function of the body function was higher than traditional abdominal surgery,chemotherapy side effects during less than traditional surgery group,the difference was statistically significant(P<0.05).Laparoscopic surgery group in the field of psychological function of emotional scored significantly higher than traditional abdominal surgery group,the difference was statistically significant(P<0.05).Conclusion:Laparoscopic colorectal cancer patients quality of life after surgery is higher than traditional surgery,is mainly reflected in the basic physiological,emotional stability and side effects of chemotherapy is lighter three aspects in the short term.Clinical medical personnel should be according to the specific situation of the different operative methods of patients with colorectal cancer,targeted to provide intervention measures to improve the patients quality of life.

Key wordsColorectal cancer;Laparoscope;Open surgery;The quality of life

结直肠癌是消化系统常见恶性肿瘤之一，近年来发生率有日益上升的趋势。20世纪90年代，临床上开始探索腹腔镜下行结直肠癌手术，由于具有疗效好、安全性高、术后并发症发生概率小等优点[1]，腹腔镜手术在治疗结直肠癌领域应用日益增多。国内外关于腹腔镜与开腹结直肠癌根治术的疗效对比报道较多[2-4]，但很少涉及生命质量。生命质量在肿瘤学领域的研究越来越受到重视，已成为衡量和评价癌症疗效的重要指标之一。本研究利用肠癌患者生命质量测定量表QLICP-CR，测定同期接受传统手术和腹腔镜根治术治疗的患者术后3个月的生命质量评分，比较两种手术方式对结直肠癌患者生命质量的影响。……