摘要
目的比较腹腔镜下保胆取石术与腹腔镜下胆囊切除术治疗儿童胆囊结石对其生长发育及生活质量的影响。方法选择2011年7月至2014年6月入住我科行腹腔镜保胆取石的患儿25例为腹腔镜保胆取石组（保胆组）,另选择同期行腹腔镜胆囊切除的患儿27例为腹腔镜胆囊切除组（切除组）。分别测定2组患儿术前及术后6个月,1、2、3年的身高、体质量及消化病生存质量指数（gastrointestinal quality of life index,GLQI）。结果保胆组及切除组术前身高及体质量分别为119 cm、22 kg及121 cm、23 kg。术后6个月,无论是保胆组还是切除组,身高及体质量均较术前增加,差异有统计学意义（P〈0.05）。术后1年,保胆组患儿的身高及体质量均超过切除组,但差异无统计学意义（P〉0.05）。术后2、3年,保胆组患儿身高及体质量的增长程度均超过切除组,差异有统计学意义（P〈0.05）,而且切除组患儿的身高及体质量均处于正常学龄期儿童平均身高及体质量的低限（正常学龄期儿童身高：136.8-144.7 cm,体质量：29.8-34.1 kg）。保胆组及切除组术前GLQI指数分别为112分及109分。术后6个月,保胆组及切除组GLQI指数均超过术前（P〈0.05）。术后1年,保胆组的GLQI指数达到正常水平（123分）,且较切除组（114分）有明显升高（P〈0.05）,主要表现在主观症状及心理情绪状态方面。术后2、3年,切除组GLQI指数（116、119分）较保胆组（124、125分）有了更明显的降低（P〈0.01）。术后第3年,切除组患儿的GLQI指数也未达到正常水平。结论腹腔镜下保胆取石术较腹腔镜下胆囊切除术更有利于患儿的生长发育及提高生存质量。
Objective To evaluate the growth and quality of life of children who underwent endoscopic minimally invasive cholecystolithotomy（ EMIC） and laparoscopic cholecystectomy（ LC） for cholecystolithiasis. Methods A prospective survey of 25 children receiving EMIC（ EMIC group） and 27 children receiving LC（ LC group） in our hospital from July 2011 to June 2014 was carried out. The height,body weight and gastrointestinal quality of life index（ GQLI） at pre-operation and in 6 month,and 1,2 and 3years after operation were separately measured. Results The mean height and body weight were 119 cm and22 kg in the EMIC group,and were 121 cm and 23 kg in the LC group at pre-operation. The height and body weight of both groups were increased significantly at the 6th month after operation compared with the preoperative values（ P〈 0. 05）. The height and body weight of the EMIC group were higher than those of the LC group at 1 year after operation,but the difference was not statistically significant（ P〈 0. 05）. The height and body weight of the EMIC group were higher than those of the LC group at 2 and 3 years after operation,and the difference was statistically significant（ P〈 0. 05）. The height and body weight of the LC group were still in the minimums of normal school-age children（ normal school-age child height： 136. 8- 144. 7 cm,body weight： 29. 8- 34. 1 kg）. The mean GLQI scores were 112 and 109 at pre-operation in the EMIC group and the LC group,respectively. The GLQI scores of both groups increased significantly at 6th month after operation compared with the preoperative scores（ P〈 0. 05）. The GLQI score of the EMIC group reached the normal level（ 123）,higher than that（ 114） of the LC group at the 1st year after operation,which was mainly in the aspect of symptomatology and psychological emotional state. At the 2nd year and 3rd year after operation,the GLQI scores（ 116,119） of the LC group were significantly lower than those（ 124,125） of the EMIC group（ P〈 0. 01）. The GLQI score of the LC group did not reach the normal level at 3rd year after operation.Conclusions EMIC is more beneficial to the growth and development of children and the improvement of quality of life than LC.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2016年第10期1144-1147,共4页
Journal of Third Military Medical University
基金
陕西省汉中市科技局科研项目(2011A02)~~
关键词
儿童
胆囊结石
腹腔镜保胆取石
腹腔镜胆囊切除术
生长发育
生活质量
children
cholecystolithiasis
endoscopic minimally invasive cholecystolithotomy
laparoscopic cholecystectomy
growth and development
quality of life
