[不同手术方式对生活质量及成本效益的影响]

[Effect of different surgical approaches on quality of life and cost-consequence].

作者信息

Leng Jin-hua, Lang Jing-he, Li Hua-jun, Liu Zhu-feng, Sun Da-wei, Zhu Lan

机构信息

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2004 May;39(5):315-8.

PMID:15196413

Abstract

OBJECTIVE

To evaluate the effects of total abdominal hysterectomy (TAH), laparoscopic hysterectomy (LH) and transvaginal hysterectomy (TVH) on quality of life, cost and health care utilization.

METHODS

A study of women who underwent elective hysterectomy was performed to assess the effect of operations on quality of life using WHO quality of life-bref before operation, at the 4th, 14th and 28th day after operation, respectively. The data of total cost and health care utilization were also analyzed.

RESULTS

The score of quality of life at the 4th day after operation in TVH patients was significantly higher than that in TAH patients (93 +/- 6 vs 81 +/- 11, P < 0.01). There was no significant difference in this score between TVH and LH, and between LH and TAH patients. However, at the 14th and 28th after operation, the scores in both TVH and LH patients were significantly higher than that in TAH patients (95 +/- 7 and 96 +/- 7 vs 85 +/- 9, P < 0.001 and 0.001; 96 +/- 10 and 98 +/- 7 vs 87 +/- 10, P < 0.01). There was no significant difference in the total costs among three groups. The better health care utilization was in LH and TVH patients, and the worse in TAH patients.

CONCLUSIONS

The effect of LH and TVH on quality of life and health economics is similar, and appears to be superior than that of TAH.

摘要

目的

评估全腹子宫切除术（TAH）、腹腔镜子宫切除术（LH）和经阴道子宫切除术（TVH）对生活质量、成本和医疗保健利用的影响。

方法

对接受择期子宫切除术的女性进行一项研究，分别在术前、术后第4天、第14天和第28天使用世界卫生组织生活质量简表评估手术对生活质量的影响。还分析了总成本和医疗保健利用的数据。

结果

TVH患者术后第4天的生活质量评分显著高于TAH患者（93±6 vs 81±11，P<0.01）。TVH与LH之间以及LH与TAH患者之间在该评分上无显著差异。然而，在术后第14天和第28天，TVH和LH患者的评分均显著高于TAH患者（95±7和96±7 vs 85±9，P<0.001和0.001；96±10和98±7 vs 87±10，P<0.01）。三组之间的总成本无显著差异。LH和TVH患者的医疗保健利用情况较好，TAH患者较差。