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前瞻性评估经阴道与经腹腔镜子宫切除术对生活质量的影响。

Prospective evaluation of quality of life in total versus supracervical laparoscopic hysterectomy.

机构信息

Brigham and Women's Hospital, Boston, MA 02115, USA.

出版信息

J Minim Invasive Gynecol. 2011 Sep-Oct;18(5):617-21. doi: 10.1016/j.jmig.2011.06.003. Epub 2011 Jul 23.

Abstract

STUDY OBJECTIVE

To evaluate and compare recovery times and quality of life (QOL) in patients undergoing a total laparoscopic hysterectomy (TLH) and laparoscopic supracervical hysterectomy (LSH).

DESIGN

Patients underwent either a TLH or LSH. After surgery, patients maintained a daily log documenting pain, nausea, use of pain medications, and return to daily activities. They also completed a QOL questionnaire (SF-36) before and after surgery.

DESIGN CLASSIFICATION

Prospective cohort study (Canadian Task Force Classification II-1).

SETTING

University teaching hospital.

PATIENTS

A total of 122 women undergoing laparoscopic hysterectomy.

MEASUREMENTS AND MAIN RESULTS

A total of 122 women underwent TLH (n = 71) or LSH (n = 51) for benign indications from February 2008 to January 2010. There was a significantly higher postoperative improvement of QOL scores in the LSH group in 6 of 10 questionnaire categories and summary scores, including physical functioning (p =.03), role physical (p =.002), and bodily pain (p =.03). There were no significant differences in use of pain medications, level of pain, level of nausea, or return to normal activities.

CONCLUSION

LSH appears to provide greater improvement in short-term postoperative QOL compared with TLH. No significant differences were found in postoperative pain or return to daily activities.

摘要

研究目的

评估和比较行完全腹腔镜子宫切除术(TLH)和腹腔镜子宫次全切除术(LSH)的患者的恢复时间和生活质量(QOL)。

设计

患者行 TLH 或 LSH。手术后,患者每天记录疼痛、恶心、使用止痛药和恢复日常活动的情况。他们还在手术前后完成了 QOL 问卷(SF-36)。

设计分类

前瞻性队列研究(加拿大任务组分类 II-1)。

设置

大学教学医院。

患者

122 例行腹腔镜子宫切除术的女性。

测量和主要结果

共有 122 名女性因良性指征于 2008 年 2 月至 2010 年 1 月行 TLH(n = 71)或 LSH(n = 51)。在 10 个问卷类别和综合评分中的 6 个类别中,LSH 组的 QOL 评分在术后有显著更高的改善,包括身体功能(p =.03)、身体角色(p =.002)和身体疼痛(p =.03)。在使用止痛药、疼痛程度、恶心程度或恢复正常活动方面,两组之间没有显著差异。

结论

与 TLH 相比,LSH 似乎在短期术后 QOL 方面提供了更大的改善。在术后疼痛或恢复日常活动方面没有发现显著差异。

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