开腹与腹腔镜下子宫肌瘤剔除术后远期生活质量比较  

Comparison of Long-term Quality of Life between after Open and Laparoscopic Myomectomy

作　　者：彭丽娜 钱林华[1] PENG Lina;QIAN Linhua(Women's Hospital School of Medicine Zhejiang University,Hangzhou 310006,China;不详)

机构地区：[1]浙江大学医学院附属妇产科医院,浙江杭州310006

出　　处：《中外医学研究》2024年第13期59-63,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:比较开腹与腹腔镜下子宫肌瘤剔除术对患者远期术后生活质量的影响,探讨最佳手术途径。方法:选取2017年1—12月于浙江大学医学院附属妇产科医院住院治疗的160例子宫肌瘤患者作为研究对象,根据治疗方式将患者分为开腹子宫肌瘤剔除术组(开腹组,n=80)和腹腔下镜子宫肌瘤剔除术组(腹腔镜组,n=80)。术后第5年进行随访,收集并记录其病史信息及随访资料,比较两组临床症状[子宫肌瘤症状严重程度问卷(uterine fibroid symptom severity scale,UFS-8)]、生命质量[欧洲五维生命质量调查问卷(European quality of life five dimension five level scale questionnaire,EQ-5D-5L)]、性生活满意度[女性性功能问卷(female sexual function index,FSFI)中的第16个问题]、术后肌瘤残留或复发情况。结果:腹腔镜组下腹部不适、乏力感评分及总分低于开腹组,差异有统计学意义(P<0.05);两组月经量增多、经血成块、经期延长、周期不规律、日间尿频、夜间尿频评分比较,差异无统计学意义(P>0.05)。腹腔镜组自我照顾、日常活动、疼痛或不舒服优于开腹组,EQ-5D-5L总分高于开腹组,差异有统计学意义(P<0.05);但两组行动能力、焦虑或沮丧比较,差异无统计学意义(P>0.05)。腹腔镜组术后性生活满意度高于开腹组,差异有统计学意义(P<0.05);但两组术后肌瘤残留或复发情况比较,差异无统计学意义(P>0.05)。结论:相比传统开腹手术,腹腔镜下子宫肌瘤剔除术术后临床症状改善更佳、生活质量提高更多,性满意度更高,但需告知若选择子宫肌瘤剔除术,术后残留及复发风险较高,术后需严密随访。Objective:To compare the effect of open and laparoscopic myomectomy on the long-term postoperative quality of life of patients,and to explore the best surgical approach.Method:A total of 160 patients with uterine fibroids who hospitalized in Women's Hospital School of Medicine Zhejiang University from January to December 2017 were selected as the research objects,the patients were divided into open myomectomy group(open group,n=80)and laparoscopic myomectomy group(laparoscopic group,n=80)according to the treatment methods.The patients were followed up for 5 years after operation,and their medical history information and follow-up data were collected and recorded,the clinical symptoms[uterine fibroid symptom severity scale(UFS-8)],quality of life[European quality of life five dimension five level scale questionnaire(EQ-5D-5L)],sexual life satisfaction[the 16 th question in the female sexual function index(FSFI)],postoperative fibroid residue or recurrence were compared between two groups.Result:The scores of lower abdominal discomfort,fatigue and total score in the laparoscopic group were lower than those in the open group,the differences were statistically significant(P<0.05);there were no significant differences in the scores of increased menstrual volume,blood clots,prolonged menstrual period,irregular cycle,daytime urinary frequency and night urinary frequency between the two groups(P>0.05).The self-care,daily activities,pain or discomfort in the laparoscopic group were superior to those in the open group,and the total score of EQ-5D-5L was higher than that of the open group,the differences were statistically significant(P<0.05);there were no significant differences in the action ability,anxiety and depression between two groups(P>0.05).The postoperative sexual life satisfaction of the laparoscopic group was higher than that of the open group,and the difference was statistically significant(P<0.05);there was no significant difference in the residual or recurrence of myoma between two groups(P>0.05).Conclusion:

关 键 词：子宫肌瘤 腹腔镜下子宫肌瘤剔除术 开腹子宫肌瘤剔除术 生活质量 

分 类 号：R737.33[医药卫生—肿瘤]