| 陈 岩,李 敏,杨晓芳,武 艳,王亚兰,王晓燕.腹腔镜手术对子宫内膜异位症患者心理状态、免疫功能、生活质量及预后的影响[J].,2018,(2):339-342 |
| 腹腔镜手术对子宫内膜异位症患者心理状态、免疫功能、生活质量及预后的影响 |
| Effect of Laparoscopic Surgery on Psychological Status, Immune Function, Quality of Life and Prognosis of Endometriosis |
| 投稿时间：2017-07-07 修订日期：2017-07-30 |
| DOI：10.13241/j.cnki.pmb.2018.02.032 |
| 中文关键词: 子宫内膜异位症 腔镜手术 心理状态 免疫功能 生活质量 预后 |
| 英文关键词: Endometriosis Endoscopic surgery Psychological status Immune function Quality of life Prognosis |
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| 摘要 目的：探讨腹腔镜手术对子宫内膜异位症（EM）患者心理状态、免疫功能、生活质量以及预后的影响。方法：选择2015年7月-2016年6月在我院接受治疗的EM患者76例，采用随机数字表法将患者分为观察组和对照组各38例。对照组给予开腹手术治疗，观察组给予腹腔镜手术治疗。比较两组患者术前、术后3个月的生存质量测定量表（QOL-BREF）评分、汉密尔顿抑郁自评量表（HAMD）评分以及汉密尔顿焦虑自评量表（HAMA）评分，比较两组患者术前、术后1d的IgG、IgM、IgA的水平，并比较两组患者术后的不良反应和1年内的复发率。结果：术后3个月，两组的心理状态、生理领域评分以及总评分均高于术前，且观察组的心理状态、生理领域评分以及总评分均高于对照组，差异有统计学意义（P<0.05）；两组患者术后3个月的HAMD、HAMA评分均较术前显著降低，且观察组低于对照组（P<0.05）。术后1d，两组患者的IgG水平较术前明显下降，且观察组的IgG水平高于对照组（P<0.05）；两组患者术后的潮热、阴道出血、性欲下降发生率比较无统计学差异（P>0.05）；术后随访1年，两组患者的复发率比较无统计学差异（P>0.05）。结论：腹腔镜手术能显著改善EM患者的心理状态和生活质量，且对免疫功能的影响较小，同时不良反应轻微，复发率较低，患者预后良好，值得临床推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of laparoscopic surgery on the psychological status, immune function, quality of life and prognosis in patients with endometriosis (EM). Methods: A total of 76 patients with EM, who were treated in Tiefa Coal Industry Group General Hospital from July 2015 to June 2016, were selected and randomly divided into observation group(n=38) and control group(n=38). The control group was treated with open surgery, and the observation group, laparoscopic surgery. The quality of life (QOL-BREF) score, Hamilton depression self rating scale (HAMD) score and Hamilton anxiety self rating scale (HAMA) score were compared between the two groups before and 3 months after operation; the levels of IgG, IgM and IgA were compared between the two groups before and 1 day after operation; the postoperative adverse reactions and recurrence rate within 1 year after operation were compared between the two groups. Results: Scores of psychological status, physiological field and the total score of two groups were higher than preoperative score, scores of psychological status, physiological field and the total score in the observation group were higher than those in the control group 3 months after surgery, the differences were statistically significant(P<0.05). The scores of HAMD and HAMA 3 months after operation in the two groups were significantly lower than those before operation,and the scores of the observation group was lower than that of the control group (P<0.05). 1 day after operation, the IgG levels of the two groups were significantly lower than those before operation, and the level of IgG in the observation group was higher than that in the control group(P<0.05). The incidence of hot flashes, vaginal bleeding and decreased libido in the two groups had no statistical difference (P>0.05). There was no significant difference in the recurrence rate between the two groups after 1 year's follow-up（P>0.05）. Conclusion: Laparoscopic surgery can significantly improve EM patients' psychological status and quality of life, and the influence on the immune function is less, the adverse reactions is mild, the recurrence rate is low, the prognosis of patients is good, which is worthy of clinical application. |
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