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[腹腔镜或开放手术治疗单纯性胆囊结石女性患者的生活质量调查]

[An investigation of the quality of life of female patients operated by laparoscopic or open way for uncomplicated cholecystolithiasis].

作者信息

Terlecka Jolanta, Majewski Włodzimierz D

机构信息

Samodzielna Pracownia Pielegniarstwa Chirurgicznego Pomorskiej Akademii Medycznej w Szczecinie ul. Zołnierska 48, 71-210 Szczecin.

出版信息

Ann Acad Med Stetin. 2007;53(1):43-52.

Abstract

INTRODUCTION

In many investigations concerning the results of surgical treatment of gallbladder stones, generally American or international data are cited, as national data are scarce, or even do not exist. This paper was written to complement Polish data with a comparison of patients' views about two methods of operating gallbladder stones commonly applied in our country. The purpose of the paper was to compare the quality of life of female patients operated for uncomplicated cholecystolithiasis in regional hospitals of Poland.

MATERIAL AND METHODS

The study material was comprised of two groups of 100 patients each, from two regional hospitals. In one of the hospitals the patients were treated only by laparoscopic cholecystectomy alone. As in the other hospital only by open cholecystecomy. The age of the patients whom were operated by open cholecystecomy varied between 19 and 90 years, median 56, mean 54.6 SD +/- 15.4 years. Whereas, in the group treated by the laparoscopic method the age varied between 23 and 72 years, median 48, mean 49.7 SD +/- 11 years. The investigation was performed between the second and twelfth month after the operation, median 6 for both, mean 6.2 SD +/- 2 for open and mean 6.9 SD +/- 2 for the laparoscopic method. BMI of the investigated patients was between 17.7 and 33.1, median 26.3, mean 26 +/- 2.7 in the open group, and between 18.1 and 34.6, median 24.2, mean 24.7 +/- 3.2 in the laparoscopic group. As a diagnostic tool a standardized Gastrointestinal Quality of Life Questionnaire (GQLI) was used, enriched by demographic questions, self-assessment of postoperative well-being, smoking habits, and postoperative pains and complications.

RESULTS

General GQLI score was within range of good quality of life in both groups. However, quality of life was significantly better in the group operated by open cholecystectomy than the one operated by the laparoscopic method (median 131 vs. 125, respectively, p < 0.022). Postoperative complications were in majority reported by patients from the open group. The possible reasons of such results are discussed in comparison with national and international results of treatment of gallbladder stones.

CONCLUSIONS

There are several other factors, which besides the entire operation, can have influence on the quality of life of patients operated for uncomplicated cholecystolithiasis. These biases can significantly change the end results of quality of life of these patients, however, quality of life remains within good limits in both groups.

摘要

引言

在许多关于胆囊结石手术治疗结果的研究中,由于缺乏本国数据,甚至根本没有本国数据,所以通常引用美国或国际数据。本文旨在通过比较我国常用的两种胆囊结石手术方法患者的观点来补充波兰的数据。本文的目的是比较波兰地区医院中接受单纯性胆囊结石手术的女性患者的生活质量。

材料与方法

研究材料由来自两家地区医院的两组患者组成,每组100人。其中一家医院的患者仅接受腹腔镜胆囊切除术治疗。另一家医院的患者仅接受开腹胆囊切除术治疗。接受开腹胆囊切除术的患者年龄在19岁至90岁之间,中位数为56岁,平均为54.6岁,标准差为±15.4岁。而接受腹腔镜手术治疗的组年龄在23岁至72岁之间,中位数为48岁,平均为49.7岁,标准差为±11岁。调查在术后第二个月至第十二个月进行,两组中位数均为6个月,开腹手术组平均为6.2个月,标准差为±2个月,腹腔镜手术组平均为6.9个月,标准差为±2个月。被调查患者的体重指数(BMI)在开腹手术组为17.7至33.1之间,中位数为26.3,平均为26±2.7;在腹腔镜手术组为18.1至34.6之间,中位数为24.2,平均为24.7±3.2。作为诊断工具,使用了标准化的胃肠道生活质量问卷(GQLI),并补充了人口统计学问题、术后幸福感自评、吸烟习惯以及术后疼痛和并发症等内容。

结果

两组的总体GQLI评分均处于良好生活质量范围内。然而,开腹胆囊切除术组的生活质量明显优于腹腔镜手术组(中位数分别为131和125,p<0.022)。开腹手术组的患者报告的术后并发症较多。结合本国和国际上胆囊结石治疗结果对这些结果可能的原因进行了讨论。

结论

除了整个手术过程外,还有其他几个因素会影响接受单纯性胆囊结石手术患者的生活质量。这些偏差可能会显著改变这些患者生活质量的最终结果,然而,两组患者的生活质量仍处于良好范围内。

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