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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。

英文摘要:

Objective: To investigate the difference of long-term quality of life (QOL) of patients who underwent surgery for esophageal cancer, two surgical methods were assessed in this prospective study. Methods: The quality of life questionnaire, EORTC QLQ-C30 Chinese version, was used to assess the patient's quality of life. All the 160 patients from April 1,2010 to April 1,2011 in our department treated for esophagectomy were collected in this study. The QLQ-C30 scores of preoperative and postoperative 3,6 and 12 months were compared with each other. Results: Compared with the preoperative and postoperative quality of life, we found that emotional function and physical function decreased significantly, dyspnea and pain were aggravated significantly, and fatigue and financial difficulties significantly increased in postoperative 3 months. Financial difficulties was restored at 12 months postoperative. Physical function, role function, emotional function and overall condition decreased significantly. That fatigue postoperative, and dyspnea 3, 6 months postoperative was increased significantly in the pneumonectomy group. Conclusion: The preoperative and postoperative quality of life compared to removal of all non-significant impact on patients quality of life. Cervical esophageal anastomosis decreased the long-term quality of life significantly than that of the intrathoracic esophageal anastomosis.

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