不同宽度管状胃对食管癌切除术后患者生活质量的影响:一项倾向配比研究
Chinese Journal of Clinical Medicine（2021）
Abstract
目的:探讨细管状胃与宽管状胃对食管癌患者术后生活质量的差异.方法:回顾性分析2018年1月至2019年12月复旦大学附属中山医院胸外科收治的行微创食管癌切除术的520例临床早期食管癌患者的病例资料,分为宽(5 cm宽度)管状胃组(n=260)和细(3 cm宽度)管状胃组(n=260),分析其围手术期外科效果指标.采用欧洲癌症治疗研究组织(EO R T C)生活质量评分量表(Q L Q C-30和O ES-18量表)对2组患者的术前和术后3、6、9、12个月的生活质量进行评价,并采用重复测量方差分析进行比较.结果:2组患者在年龄、性别、体质量指数、合并疾病指数、麻醉风险分级、肿瘤部位和术后病理分期等临床特征方面的差异均无统计学意义,在出血量、术后住院天数、总体并发症发生率方面的差异均无统计学意义.细管状胃组的相关手术耗材费用较高[(0.79±0.04)万元v s(0.58±0.05)万元,P=0.000].2组患者的生活质量各项指标在术前基线水平的差异均无统计学意义,而在术后有不同程度的恶化,但均随时间延长而逐渐改善.重复测量方差分析结果显示,除时间效应外,细管状胃组术后在整体状况评分、呼吸不适、反流症状、咳嗽等4项指标方面明显优于宽管状胃组,差异有统计学意义(P<0.05).结论:采用细管状胃的食管癌患者术后生活质量更好.
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