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目的:探讨食管癌传统开胸手术中不同术式对术后长期生活质量(QOL)影响。方法:回顾性调查2010年4月1日至2011年4月1日在我科例行传统开胸手术颈部吻合和胸内吻合的160食管癌患者,将其分为两组,A组:颈部吻合手术;B组:胸内吻合手术。采用生活质量测定量表核心量表(QLQ-C30),对其术前和术后3,6和12个月的QLQ-C30得分与参考值进行比较。结果:术后情绪功能,体力功能显着下降;症状方面,术后呼吸困难,疼痛明显加重;术后第3个月疲乏及经济困难明显加重;术后第12个月起,经济困难状况好转,较术前无明显差异;术后颈部吻合手术组较胸内吻合手术组在体力功能、角色功能、情绪功能及总体状况显著的降低;症状方面,颈部吻合手术组较胸内吻合手术组,术后疲乏显著升高,呼吸困难术后显著升高直至术后第12个月才基本恢复,无统计学差异。结论:术后生活质量与术前比较,颈部吻合对患者生活质量影响明显。比较两种方法,颈部吻合患者较胸内吻合患者术后长期生活质量下降明显。
Objective: To investigate the effect of different surgical procedures on postoperative long-term quality of life (QOL) in traditional open-chest surgery of esophageal cancer. Methods: A retrospective survey of 160 esophageal cancer patients with cervical anastomosis and thoracic anastomosis from April 1, 2010 to April 1, 2011 in our department was conducted and divided into two groups. Group A: Neck anastomosis surgery; B group: intrathoracic anastomosis. QLQ-C30 scores were compared with reference values before and 3,6 and 12 months postoperatively using the QLQ-C30 core quality of life questionnaire. Results: Postoperative emotional function and physical function decreased significantly. In terms of symptoms, postoperative dyspnea and pain were significantly aggravated. The third month after operation, fatigue and economic difficulties were significantly aggravated. From the 12th month after operation, the economic difficulties improved , No significant difference compared with the preoperative; neck anastomosis surgery group than in the anastomosis surgery group in physical function, role function, emotional function and the overall condition significantly reduced; symptoms, cervical anastomosis surgery group than intrathoracic anastomosis Group, postoperative fatigue was significantly increased, dyspnea increased significantly after surgery until 12 months after the basic recovery, no statistically significant difference. Conclusion: The postoperative quality of life compared with preoperative, cervical anastomosis on the quality of life of patients significantly. Comparing the two methods, the long-term quality of life of patients with cervical anastomosis was significantly lower than that of patients with intrathoracic anastomosis.