腹腔镜胆囊切除对患者生存质量与医疗效率影响的研究

目的比较腹腔镜手术（LC）与开腹手术（OC）行胆囊切除术的患者生存质量的差异，阐析腹腔镜手术的医疗效率。方法采用GIQI生存质量指标测定40例腹腔镜胆囊切除术及40例开腹胆囊切除术患者在术前及术后2、5、10、16周的生存质量值。结果LC组和OC组术前平均GLQI指数分别为110分和109分（P〉0.05）。Lc组患者术后2周时的GLQI指数为108分，下降不明显（P〉0.05），手术5周以后，GLQI指数和主观症状、躯体生理功能状态、心理情绪状态各方面均显著高于术前（P〈0．05）。OC组患者术后2周时GLQI指数为101分，降幅明显（P〈0．05），术后5周时GLQI指数为108分，恢复至术前水平（P〉0．05），手术10周以后，GLQI指数和上述3项分值均明显超出术前水平（P〈0．05）。手术10周内，LC组GLQI指数显著高于OC组（P〈0．05）。结论腹腔镜胆囊切除手术较开腹手术更有利于患者术后恢复，能提高生活质量和医疗效率。

A study on relation between quality of life and medical efficiency in laparoscopic cholecystectomy patients

Objective To evaluate and compare the quality of life in patients of laparoscopic cholecystectomy to open cholecystectomy. Methods A survey was made on 40 patients receiving laparoscopic cholecystectomy(LC group) and 40 patients with open cholecystectomy(OC group).The quality of life was measured with the Gastrointestinal Quality of Life Index(GLQI) preoperatively,and on 2,5,10 and 16 weeks after the operation.Results The mean preoperative overall GLQI scores were 110 and 109 in LC and OC group respectively(P>0.05).In LC group,GLQI score reduced slightly to 108 two weeks after the operation(P>0.05).The LC group showed significant improvement in GLQI score and in the rational symptom,physiological function,emotional and physiological status from 5 to 16 weeks postoperatively.In OC group,the GLQI score reduced to 101 two weeks after surgery(P<0.05).Significant reductions were shown in the rational symptom,physiological function,physiological and psycho-emotional state.The GLQI scores returned to the preoperative level of 108,five weeks after the operation(P>0.05).The patients experienced significant improvements of GLQI ten weeks after OC operation(P<0.05).Within the 10 postoperative weeks,the LC group had significantly higher GLQI scores than the OC group(P<0.05).Conclusion LC can improve the quality of life postoperatively better and more rapidly than OC,and can also improve the medical efficiency.