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目的评估腹腔镜和开腹切除两种手术方式对胃间质瘤患者术后生活质量的影响。方法回顾性调查2011年5月~2016年8月四川大学华西医院接受胃间质瘤切除术(胃部分切除术)的患者。比较腹腔镜与开腹手术患者的基线资料、术后并发症、术后肛门排气时间、术后住院时间、术中出血量和住院费用,使用SF-36生活质量量表评估患者术后生活质量。采用SPSS 19.0软件进行统计分析。结果共纳入89例患者,其中腹腔镜组31例,开腹手术组58例。两组基线资料差异无统计学意义。腹腔镜组的术后肛门排气时间、术后住院时间更短,术中出血量更少,住院总费用更低,两组差异有统计学意义(P<0.05)。但两组在手术时间、术后并发症总发生率等方面,差异无统计学意义(P>0.05)。腹腔镜组和开腹手术组患者SF-36生活质量量表总分分别为737.7±68.3分和665.1±138.1分,腹腔镜组在精力(VT)、社会功能(SF)、精神健康(MH)方面的评分更高,两组差异有统计学意义(P<0.05)。结论腹腔镜治疗胃间质瘤安全有效,比开腹手术创伤更小、患者恢复更快,且患者术后生活质量更好。但受研究设计限制,上述结论还有待更多高质量研究验证。
Objective To evaluate the effect of laparoscopic and open excision on postoperative quality of life in patients with gastric stromal tumors. Methods Retrospective investigation from May 2011 to August 2016 in West China Hospital of Sichuan University underwent gastric stromal tumor resection (partial gastrectomy) patients. Comparisons of baseline data, postoperative complications, postoperative anal exhaust time, postoperative hospital stay, intraoperative blood loss, and hospitalization costs were compared between patients undergoing laparoscopic surgery and laparotomy for postoperative survival using the SF-36 Quality of Life Scale quality. Using SPSS 19.0 software for statistical analysis. Results A total of 89 patients were enrolled, including 31 cases of laparoscopic group and 58 cases of laparotomy group. There was no significant difference between the two groups of baseline data. The time of postoperative anal exhaust in laparoscopic group, shorter postoperative hospital stay, less intraoperative blood loss and lower total cost of hospitalization were significantly different between the two groups (P <0.05). However, there was no significant difference between the two groups in the operation time and the total incidence of postoperative complications (P> 0.05). The total score of SF-36 quality of life in patients with laparoscopic surgery and open surgery was 737.7 ± 68.3 and 665.1 ± 138.1 respectively. There were significant differences in the scores of VT, social function (SF), mental health (MH) Score higher, the difference between the two groups was statistically significant (P <0.05). Conclusion Laparoscopic treatment of gastric stromal tumors is safe and effective, less invasive than open surgery, patients recover faster, and patients with better quality of life after surgery. However, due to research and design limitations, the above conclusion still needs more high-quality research and verification.