摘要
目的:研究腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)后患者生活质量,分析术后不同时间段患者生活质量的差异,并探讨LC术后消化性溃疡、胆汁反流性胃炎、结直肠癌的发生风险。方法:应用消化系统疾病生活质量量表(gastrointestinal quality of life index,GIQLI)、三个自设问题电话随访2009年11月至2016年8月行LC的900例患者,详细记录生活质量相关数据,并按手术日期将患者分为术后6~12个月、术后1~5年及术后5年以上3组。对比3组患者术后GIQLI评分,多重线性回归分析影响患者术后GIQLI自觉症状评分的危险因素,观察术后新发消化性溃疡、胆汁反流性胃炎及结直肠癌的患病率。结果:共获得846份随访结果,失访率6%,中位随访时间39个月。3组患者的GIQLI总分[(114.4±18.2)、(118.1±17.5)、(118.2±17.9),P<0.05)]、自觉症状评分[(62.5±10.3)、(65.3±9.5)、(65.8±9.7),P<0.001)]差异有统计学意义;性别(P=0.027)与患者术后生活质量相关,而年龄、体质量指数与患者术后生活质量不相关(P>0.10),术后新发消化性溃疡29例(3.4%)、胆汁反流性胃炎37例(4.4%),随访未见结直肠癌。结论:术后6~12个月的患者生活质量低于术后1~5年、术后5年以上的患者,而在自觉症状方面更为显著。女性是影响患者术后生活质量的独立危险因素。LC增加了消化性溃疡、胆汁反流性胃炎的发病率,未发现LC与结直肠癌相关的证据。
Objective： To study the quality of life of patients at different periods after laparoscopic cholecystectomy（ LC） and the risk of peptic ulcer,bile reflux gastritis and colorectal cancer after LC. Methods： A cohort of 900 patients who underwent LC in the PLA General Hospital between Nov. 2009 and Aug. 2016 were followed up by phone with the gastrointestinal quality of life index（ GIQLI） and three self-designed questions. Patients were divided into three groups according to the date of surgery： 6-12 months after surgery,1-5 years after surgery and more than 5 years after surgery. The GIQLI scores were compared among the three groups of patients. Multiple linear regression analysis was used to analyze the risk factors of GIQLI symptomatology score. The morbidity of new-onset peptic ulcer,bile reflux gastritis and colorectal cancer after surgery were observed. Results： There were a total of 846 follow-up results,the loss ratio of follow-up was 6%,the median follow-up time was 39 months. Three groups of patients had statistical differences in GIQLI total scores [（ 114. 4 ± 18. 2）,（ 118. 1 ± 17. 5）,（ 118. 2 ± 17. 9）,P〈0. 05） ] and symptomatology scores [（ 62. 5 ± 10. 3）,（ 65. 3 ±9. 5）,（ 65. 8 ± 9. 7）,P〈0. 001） ]. Gender（ P = 0. 027） was associated with postoperative quality of life,while age and body mass index were not（ P〉0. 10）. There were 29 cases（ 3. 4%） of newly diagnosed peptic ulcer and 37 cases（ 4. 4%） of bile reflux gastritis after surgery. No patients were diagnosed with colorectal cancer during the follow-up. Conclusions： The 6-12 months group has lower postoperative quality of life and severer self-conscious symptoms than the other two groups. Female is the independent risk factor affecting postoperative quality of life in patients. LC increases the morbidity of peptic ulcer and bile reflux gastritis. But no association evidence is found between LC and colorectal cancer.
作者
豆松萌
赵森峰
刘博
DOU Song-meng;ZHAO Sen-feng;LIU Bo(Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China)
出处
《腹腔镜外科杂志》
2018年第2期91-94,共4页
Journal of Laparoscopic Surgery
关键词
胆囊切除术
腹腔镜
生活质量
危险因素
Cholecystectomy, laparoscopic
Quality of life
Risk factors
