CAJ | 학술논문

目的：观察手助腹腔镜手术（HALS）辅助下结直肠癌切除术的临床疗效及术后生活质量。方法将该院2012年7月—2013年10月收治的，行结直肠癌切除术后的患者90例分为三组，其中开腹手术患者30例，全腹腔镜手术患者30例，手助腹腔镜手术患者30例。分别于术前和术后1月追踪肝肾功能和血常规变化情况及临床效果；于术前和术后12月评估患者肝肾功能及生活重量。结果3组患者手术前、后血常规和肝肾功能指标变化均无统计学差异。HALS组在术中出血量、术后肠道功能恢复时间、术后住院时间明显优于开腹组；HALS组在术中出血量和术中手术时间优于全腹腔镜组。术后1年，3组患者在整体健康状况、躯体功能、情绪功能、疲劳、恶心呕吐、疼痛症状、便秘及腹泻等生活质量明显优于术前。手助腹腔镜手术患者在整体健康状况、疲劳、恶心呕吐、疼痛症状、便秘及腹泻等生活质量明显优于其他两组。结论 HALS具有安全性高、手术时间短、创伤小、出血少、术后恢复快等优点。结直肠癌切除术后的患者经开腹手术、全腹腔镜手术及HALS均能有效改善患者生活质量，其中HALS在提供患者生活质量方面更加有效，是一种理想的结直肠癌患者手术方式。
목적：관찰수조복강경수술（HALS）보조하결직장암절제술적림상료효급술후생활질량。방법장해원2012년7월—2013년10월수치적，행결직장암절제술후적환자90례분위삼조，기중개복수술환자30례，전복강경수술환자30례，수조복강경수술환자30례。분별우술전화술후1월추종간신공능화혈상규변화정황급림상효과；우술전화술후12월평고환자간신공능급생활중량。결과3조환자수술전、후혈상규화간신공능지표변화균무통계학차이。HALS조재술중출혈량、술후장도공능회복시간、술후주원시간명현우우개복조；HALS조재술중출혈량화술중수술시간우우전복강경조。술후1년，3조환자재정체건강상황、구체공능、정서공능、피로、악심구토、동통증상、편비급복사등생활질량명현우우술전。수조복강경수술환자재정체건강상황、피로、악심구토、동통증상、편비급복사등생활질량명현우우기타량조。결론 HALS구유안전성고、수술시간단、창상소、출혈소、술후회복쾌등우점。결직장암절제술후적환자경개복수술、전복강경수술급HALS균능유효개선환자생활질량，기중HALS재제공환자생활질량방면경가유효，시일충이상적결직장암환자수술방식。
Obiective To investigate the clinical effect and life quality of colorectal cancer patients after hand-assisted laparoscopic sur-gery.Methods A total of 90 colorectal cancer patients from July 2012 to October 2013 were divided into 3 groups:laparotomy group, laparoscopy group and hand-assisted laparoscopic surgery group.Liver and kidney functions were monitored.The clinical effect and life quality were documented before operation and 1 year after operation.Results No significant differences were found between these groups in terms of the function parameters of liver and kidney before and after operation.In HALS group,intraoperative bleeding vol-ume,postoperative intestinal function recovery time,postoperative duration of hospital stay were significantly better than laparotomy group.In HALS group,the amount of bleeding and operation time were better than laparoscopic group.The life quality in all three groups was significantly improved one year after surgery in terms of general status,physical function,emotional function,fatigue,nausea/vomiting,pain,constipation and diarrhea.After one year of surgery,patients of the hand-assisted laparoscopic surgery group were superi-or than the other two groups in terms of general status,fatigue,nausea/vomiting,pain,constipation and diarrhea.Conclusions HALS has the advantages of high safety level,short operation time,less trauma,less bleeding,faster postoperative recovery etc..Three surgery methods can improve health status and life quality in colorectal cancer patients,andthe hand-assisted laparoscopic surgery is the pre-ferred surgery method.