腹腔镜微创手术治疗对结肠癌患者性生活能力及胃肠道功能的影响

摘要

目的：探讨腹腔镜手术对结肠癌患者性生活能力以及胃肠道功能的影响。方法选取2008年4月至2014年6月北京市房山区良乡医院收治的结肠癌患者72例，采用抽签法分成腹腔镜组和开腹组，各36例。腹腔镜组患者行腹腔镜微创手术治疗，开腹组行常规开腹结肠根治术治疗。通过调查问卷对患者术后性功能情况进行评分，对比两组患者术后一般情况，性生活能力、胃肠道功能以及术后并发症发生情况。结果腹腔镜组患者在术中失血量少于开腹组[（83.2±15.4） mL 比（133.7±16.5） mL]、住院时间、镇痛时间以及肠道功能恢复时间均短于开腹组[（6.5±1.9） d 比（14.8±2.2） d；（1.2±0.4） d比（3.4±0.6） d；（2.5±0.4） d 比（3.6±0.5） d]，差异均有统计学意义（ P＜0.01）；腹腔镜组患者术后进食流质食物时间、进食普通食物时间、术后肛门排气时间以及术后下床时间均短于对照组[（2.2±0.5） d 比（3.6±0.4） d；（3.5±0.9） d 比（4.7±0.8） d，（2.2±0.3） d 比（3.2±0.5） d，（2.8±0.4） d 比（3.6±0.2） d]，差异也有统计学意义（P＜0.01）；两组患者术后性欲低下评分、术后性厌恶评分组间、时点间以及组间·时点间比较差异均无统计学意义（P＞0.05）；术后腹腔镜组患者并发恶心呕吐、便秘、腹泻、失眠的发生率均显著低于开腹组，差异有统计学意义（ P＜0.05）。结论腹腔镜结肠癌根治术相比于常规开放手术能有效改善患者术后胃肠道功能，同时减少术后并发症的发生，但对性生活能力的恢复无明显影响。%Objective To evaluate the effect of laparoscopy on sexual ability and gastrointestinal func-tion in colon cancer patients.Methods Total of 72 colon cancer patients in Liangxiang Hospital from Apr. 2008 to Jun.2014 were included in the study and divided into a laparoscopic group and a laparotomy group by sortation method.The laparoscopic group received minimally invasive surgery under laparoscope,while the laparotomy group received conventional laparotomy.The sexual ability of patients was evaluated by question-naire,and the postoperative sexual ability,gastrointestinal function and complications of the two groups were compared.Results Blood loss,length of hospital stay,duration of analgesia and bowel function recovery time of the laparoscopic group were less than the laparotomy group[(83.2 ±15.4) mL vs (133.7 ±16.5) mL;(6.5 ±1.9) d vs (14.8 ±2.2) d;(1.2 ±0.4) d vs (3.4 ±0.6) d;(2.5 ±0.4) d vs (3.6 ±0.5) d], the differences were statistically significant(P<0.01).The eating liquid food time,eating regular food time, postoperative anal exhaust time and postoperative ambulation time of the laparoscopic group were shorter than the laparotomy group[(2.2 ±0.5) d vs (3.6 ±0.4) d;(3.5 ±0.9) d vs (4.7 ±0.8) d;(2.2 ±0.3) d vs (3.2 ±0.5) d;(2.8 ±0.4) d vs (3.6 ±0.2) d](P<0.01).The postoperative libido score and sexual aversion score had no statistically significant difference between groups,different time points and groups· dif-ferent time points ( P >0.05 ) .The incidence of postoperative nausea, vomiting, constipation, diarrhea and insomnia of the laparoscopic group were significantly lower than the laparotomy group,the differences were statistically significant(P<0.05).Conclusion The laparoscopic surgery compared with the conventional laparoscopy,not only improves the recovery of gastrointestinal function of the patients,but also reduces the incidence of postoperative complicationsy,without significant influence the recovery of sexual ability.