标题：腹腔镜与开腹手术治疗结肠癌的临床疗效和术后生活质量比较

      作者：宋小康，李兴华，毛常青，李惠华    (中山大学附属第三医院粤东医院普外科，广东 梅州 514000)

      卷次： 2017年28卷20期

      【摘要】 目的 比较腹腔镜与开腹手术治疗结肠癌的临床疗效和术后生活质量况。方法 分析中山大学附属第三医院粤东医院2014年5月至2016年3月收治的60例结肠癌患者的临床资料，依据手术方式分为腹腔镜组30例和开腹组30例。观察两组结肠癌患者临床疗效、预后以及术前、术后的生活质量评分情况。结果 开腹组和腹腔镜组淋巴结清扫数目[(25.1±5.0) cm和(24.8±5.6) cm]、切除标本长度[(17.8±5.4) cm和(16.8±5.3) cm]、肿瘤远端长度[(3.1±1.5) cm和(2.8±1.4) cm]差异均无统计学意义(P>0.05)，结肠癌患者术前疼痛[(66.8±10.8)分和(67.5±10.4)分]、饮食受限[(66.2±10.1)分和(67.1±10.3)]分、焦虑[(66.2±10.1)分和(67.6±10.3)]分、排便功能评分[(66.1±10.2)分和(67.1±10.3)分]差异均无统计学意义(P>0.05)；腹腔镜组结肠癌患者局部复发率(6.7%)、远处转移率(6.7%)均低于开腹组的26.7%、26.7%，术后开腹组和腹腔镜组疼痛[(76.8±10.1)分和(87.9±10.5)分]、饮食受限[(76.6±10.2)分和（87.5±10.4）分]、焦虑[(76.3±10.5)分和(87.9±10.6)分]、排便功能评分[(76.6±10.4)分和(87.5±10.3)分]均高于术前，腹腔镜组术后结肠癌患者疼痛、饮食受限、焦虑、排便功能评分均高于开腹组，差异均有统计学意义(P<0.05)。结论 腹腔镜与开腹手术治疗结肠癌均有较好的临床疗效，而腹腔镜手术预后和生活质量更好。
      【关键词】 腹腔镜；开腹手术；结肠癌；临床疗效；生活质量
      【中图分类号】 R735.3+5 【文献标识码】 A 【文章编号】 1003—6350（2017）20—3312—03

Clinical effect of laparoscopic surgery versus laparotomy in the treatment of colon cancer and patients'postoperative quality of life.
SONG Xiao-kang, LI Xing-hua, MAO Chang-qing, LI Hui-hua. Department of GeneralSurgery, the Third Affiliated Hospital of Sun Yat-Sen University·Yuedong Hospital, Meizhou 514000, Guangdong, CHINA
【Abstract】 Objective To investigate the clinical effect of laparoscopic surgery versus laparotomy in the treat-ment of colon cancer and to evaluate the patients' postoperative quality of life. Methods Sixty patients of colon cancer inour hospital from May 2014 to March 2016 were enrolled and divided into two groups by different operation methods: lap-aroscopic surgery group (30 patients) and laparotomy group (30 patients). The clinical effects, prognosis, and quality oflife before and after operation were detected. Results The number of dissected lymph nodes, length of removed speci-men, and tumor distal length were (25.1±5.0) cm, (17.8±5.4) cm, (3.1±1.5) cm in laparotomy group, versus (24.8±5.6) cm,(16.8±5.3) cm, (2.8±1.4) cm in laparoscopic surgery group (P>0.05). Before operation, the scores of pain, dietary restric-tions, anxiety, bowel function were (66.8±10.8), (66.2±10.1), (66.2±10.1), (66.1±10.2) in laparotomy group, versus(67.5±10.4), (67.1±10.3), (67.6±10.3), (67.1±10.3) in laparoscopic surgery group (P>0.05). The local recurrence rate, dis-tant metastasis rate were 6.7%, 6.7% in laparoscopic surgery group, significantly lower than 26.7%, 26.7% in laparotomygroup. After operation, the scores of pain, dietary restrictions, anxiety, bowel function were significantly higher than thosebefore operation, which were (76.8±10.1), (76.6±10.2), (76.3±10.5), (76.6±10.4) in laparotomy group and (87.9±10.5),(87.5±10.4), (87.9±10.6), (87.5±10.3) in laparoscopic surgery group, and the scores in the laparoscopic surgery group weresignificantly higher than those in laparotomy group (P<0.05). Conclusion Laparoscopic surgery and laparotomy bothhave good clinical effect in the treatment of colon cancer, but the former brings better prognosis and higher quality of life.
      【Key words】 Laparoscopic; Laparotomy; Colon cancer; Clinical effects; Quality of life·论 著·doi:10.3969/j.issn.1003-6350.2017.20.015基金项目：梅州市科技计划项目（编号：2016B107）