手助腹腔镜手术辅助下结直肠癌切除术的临床观察及术后生活质量研究  

Study on the clinical effect and life quality of colorectal cancer patients afterhand-assisted laparoscopic surgery

作　　者：汪正广[1] 齐东江 祁义军[1] 刘虎[1] 张力[1] 孟翔凌[1] 

机构地区：[1]安徽医科大学第一附属医院干部外科,安徽合肥230032

出　　处：《安徽医药》2015年第5期899-902,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的观察手助腹腔镜手术(HALS)辅助下结直肠癌切除术的临床疗效及术后生活质量。方法将该院2012年7月—2013年10月收治的,行结直肠癌切除术后的患者90例分为三组,其中开腹手术患者30例,全腹腔镜手术患者30例,手助腹腔镜手术患者30例。分别于术前和术后1月追踪肝肾功能和血常规变化情况及临床效果;于术前和术后12月评估患者肝肾功能及生活重量。结果 3组患者手术前、后血常规和肝肾功能指标变化均无统计学差异。HALS组在术中出血量、术后肠道功能恢复时间、术后住院时间明显优于开腹组;HALS组在术中出血量和术中手术时间优于全腹腔镜组。术后1年,3组患者在整体健康状况、躯体功能、情绪功能、疲劳、恶心呕吐、疼痛症状、便秘及腹泻等生活质量明显优于术前。手助腹腔镜手术患者在整体健康状况、疲劳、恶心呕吐、疼痛症状、便秘及腹泻等生活质量明显优于其他两组。结论 HALS具有安全性高、手术时间短、创伤小、出血少、术后恢复快等优点。结直肠癌切除术后的患者经开腹手术、全腹腔镜手术及HALS均能有效改善患者生活质量,其中HALS在提供患者生活质量方面更加有效,是一种理想的结直肠癌患者手术方式。Obiective To investigate the clinical effect and life quality of colorectal cancer patients after hand-assisted laparoscopic sur-gery.Methods A total of 90 colorectal cancer patients from July 2012 to October 2013 were divided into 3 groups：laparotomy group, laparoscopy group and hand-assisted laparoscopic surgery group.Liver and kidney functions were monitored.The clinical effect and life quality were documented before operation and 1 year after operation.Results No significant differences were found between these groups in terms of the function parameters of liver and kidney before and after operation.In HALS group,intraoperative bleeding vol-ume,postoperative intestinal function recovery time,postoperative duration of hospital stay were significantly better than laparotomy group.In HALS group,the amount of bleeding and operation time were better than laparoscopic group.The life quality in all three groups was significantly improved one year after surgery in terms of general status,physical function,emotional function,fatigue,nausea/vomiting,pain,constipation and diarrhea.After one year of surgery,patients of the hand-assisted laparoscopic surgery group were superi-or than the other two groups in terms of general status,fatigue,nausea/vomiting,pain,constipation and diarrhea.Conclusions HALS has the advantages of high safety level,short operation time,less trauma,less bleeding,faster postoperative recovery etc..Three surgery methods can improve health status and life quality in colorectal cancer patients,andthe hand-assisted laparoscopic surgery is the pre-ferred surgery method.

关 键 词：结直肠癌 手助腹腔镜 生活质量 

分 类 号：R735.34[医药卫生—肿瘤]