绝经过渡期子宫肌瘤患者腹腔镜不同术式术后生活质量的研究

Analysis of postoperative quality of life after laparoscopic surgery in postmenopausal transition patients with uterine leiomyoma

关键词:  子宫肌瘤  腹腔镜  生活质量  绝经过渡期

Key words:  [Key words]　uterine fibroids  laparoscopic  the quality of life  peri-menopausal period

摘要:

[摘要]　目的　评价腹腔镜子宫肌瘤剔除术和腹腔镜全子宫切除术两种术式对绝经过渡期子宫肌瘤患者术后生活质量的影响。　方法　选择绝经过渡期因子宫肌瘤于大连医科大学附属妇产医院行腹腔镜肌瘤剔除术者30例，腹腔镜子宫全切除术者30例，采用SF-36量表、绝经过渡期症状调查表和性生活调查表，评估术后6个月不同术式对患者生活质量的影响。　结果　SF-36量表信度评价8个维度克朗巴赫系数为0.729～0.831，效度评价各维度均为高度相关。术后6个月腹腔镜肌瘤剔除组的SF-36总分明显高于术前，也高于全子宫切除组（P<0.05）；腹腔镜肌瘤剔除组术后躯体职能、一般健康状况、社交功能、情感职能和精神健康5个维度评分高于术前（P<0.05），全子宫切除组术后躯体功能、躯体职能、一般健康状况、社交功能、情感职能和精神健康6个维度评分均低于术前（P<0.05）。术后6个月腹腔镜全子宫切除组患者的潮热汗出、焦虑忧郁、疲劳乏力的发生率显著高于肌瘤剔除组（P<0.05）。术后6个月腹腔镜全子宫切除组患者的性欲降低、阴道干燥和性焦虑的发生率高于腹腔镜肌瘤剔除组（P<0.05）。　结论　SF-36量表用于子宫肌瘤患者生活质量评价具有良好的性能。绝经过渡期子宫肌瘤患者行腹腔镜肌瘤剔除术术后生活质量、绝经过渡期不适合和性生活质量均好于腹腔镜子宫切除患者。

Abstract:

[Abstract]　Objective　To compare the quality of life (QOL) among women in the peri-menopausal period, who underwent laparoscopic myomectomy (LM) or laparoscopic total hysterectomy (LTH).　Methods　60 cases with uterine fibroid were selected from Dalian Obstetrics and gynecology hospital affiliated to Dalian Medical University, 30 of which undergoing LM and 30 with LTH. The Short Form-36 (SF-36) questionnaire, menopausal symptoms questionnaire and sexual life questionnaire were used to evaluate different operations.　Results　SF-36 may reflect the QOL among women with uterine fibroid roundly. SF-36 total score of LM group was obviously higher than those of preoperative and LTH group (P<0.05). The score of LM group in the postoperative body functions, general health, social function, emotional function and mental health were higher than the preoperative group (P<0.05); while the score of LTH group in postoperative physical function, physical function, general health, social function, emotional function, and mental health scores were lower than the preoperative group (P<0.05). The incidence rate of symptoms such as hot flashes, anxiety, depression, fatigue were higher in LTH group than those in LM group (P<0.05). In the aspect of sexual life, the patient who took LTH announced higher occurrence of lower sexual desire, vaginal dryness and sexual anxiety (P<0.05).　Conclusion　SF-36 has a good performance in evaluating QOL in patients with hysteromyoma. LM has little effect on menopausal symptoms and sexual life while improving QOL. LM is an appropriate surgical treatment option in clinic.