摘要
目的对比分析腹腔镜下膀胱根治性全切术与开放性手术的疗效。方法将我院2013年6月~2014年6月住院行腹腔镜下膀胱根治性全切术患者30例作为研究对象,设为腹腔镜组,另选择同期行开放性手术患者30例为对照组,比较两组的手术时间、术中出血量、下床活动时间、住院时间;术后并发症情况：包括造口脱垂、回缩、吻合口狭窄、尿路感染、尿失禁。出院后6个月应用SF-6生活质量量表对两组患者的生活质量各项评分进行比较。结果腹腔镜组30例无一例中转开腹,无围手术期死亡。腹腔镜组患者的术中出血量显著少于对照组,差异有统计学意义（P〈0.05）。腹腔镜组患者的下床活动时间、术后住院时间显著短于对照组,差异有统计学意义（P〈0.05）。腹腔镜组术后无一例出现造口脱垂、吻合口狭窄,其并发症发生率达10.0%,显著低于对照组的40.0%,差异有统计学意义（P〈0.05）。腹腔镜组患者SF-6生活质量中的躯体功能、躯体角色受限、机体疼痛、总体健康自评、活力、社会功能、情感角色受限、心理健康各项评分均较对照组改善更显著,差异有统计学意义（P〈0.05）。结论腹腔镜下膀胱根治性全切术较开放性手术相比手术疗效确切,具有手术时间短、出血少、并发症少、患者术后恢复快等优点,且可显著提高患者的生活质量。
Objective To compare the efficacy of laparoscopic bladder radical hysterectomy and open operation. Methods From June 2013 to June 2014 in our hospital, 30 cases underwent laparoscopic bladder in patients undergoing radical hysterectomy were selected as the research objects, as the establishment of the laparoscopic group, 30 cases at the same period also underwent open operation were et up as the control group, operation time, intraoperative bleeding volume, get out of bed activity time, hospitalization time and postoperative complications; including stoma prolapse, retraction, anastomotic stricture, urinary tract infection, urinary incontinence were compared. The application of SF-6 quality of life scale for two groups of patients’ quality of life scores were compared from hospital after 6 months.Results Laparoscopic group（30 cases） had no case of secondary laparotomy, no operation period death. The amount of bleeding in operation of the patients in laparoscopic group was significantly less than that in the control group, the difference was statistically significant（P〈0.05）. Laparoscopic patients out of bed activity time, postoperative hospitalization time was significantly shorter than that in the control group, the difference was statistically significant（P〈0.05）.There was no stoma prolapse, anastomotic stenosis after laparoscopic group, the complication rate was 10.0%, significantly lower than the control group’s the incidence of postoperative complications 40.0%, the difference was statistically significant（P〈0.05）. The quality of life of SF-6 in the laparoscopic group in physical function, role physical, bodily pain, limited overall self-rated health, vitality, social function, emotional role limitation, mental health scores compared with the control group improved more significantly（ P〈0.05）. Conclusion Laparoscopic bladder radical hysterectomy operation compared with open operation compared with exact curative effect, short operation time, less bleeding, fewer complications,
出处
《中国现代医生》
2015年第18期44-47,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划(2011KYB066)
