低位直肠癌保肛术行回肠造口与单做保肛术的疗效比较

发布时间：2018-03-01 06:37

本文关键词： 低位直肠癌保肛术回肠造口低位直肠癌临床疗效　出处：《广东医学》2017年07期 　论文类型：期刊论文

【摘要】：目的研究低位直肠癌保肛术联合回肠造口治疗低位直肠癌的临床疗效。方法选取低位直肠癌114例,采用随机数字法将其分为对照组和观察组,每组各57例。对照组患者仅接受低位直肠癌保肛术治疗,观察组患者在对照组基础上联合回肠造口治疗。比较两组患者的恢复排气排便时间、恢复进食时间、住院时间,同时比较吻合口瘘、吻合口狭窄等并发症发生率,同时比较术前、术后6个月及1年的Wexner评分和术后1年的大小便失禁生活质量问卷(FIQL)评分。结果观察组的恢复排气排便时间、恢复进食时间、住院时间均明显低于对照组(P0.01),观察组的吻合口瘘发生率(1.75%)明显低于对照组(15.79%),差异有统计学意义(醊2=7.01,P=0.00);观察组的吻合口狭窄发生率(1.75%)明显低于对照组(10.53%),差异有统计学意义(醊2=4.13,P=0.04);手术后6个月和1年,观察组的Wexner评分均明显低于对照组(P0.01);手术后1年,观察组的生活方式、心理应付/行为、抑郁/自我感受、窘迫尴尬等FIQL评分均明显高于对照组(P0.05)。结论预防性回肠造口能明显降低低位直肠癌保肛术术后吻合口瘘等并发症,促进患者排气排便功能恢复,缩短住院时间,并能有效提高生活质量,值得在临床推广。
[Abstract]:Objective to study the clinical effect of anus-preserving operation combined with ileostomy in the treatment of low rectal cancer. Methods 114 cases of low rectal cancer were randomly divided into two groups: control group and observation group. There were 57 cases in each group. The patients in the control group were only treated with anus-preserving surgery for low rectal cancer, while the patients in the observation group were treated with ileostomy on the basis of the control group. The recovery time of exhaust defecation, the time of food recovery, and the time of hospitalization were compared between the two groups. At the same time, the incidence of anastomotic leakage, anastomotic stenosis and other complications were compared. The Wexner score before operation, 6 months and 1 year after operation, and the quality of life questionnaire (FIQL) score of incontinence and urinal incontinence 1 year after operation were compared. Results the time of recovery of exhaust and defecation in the observation group was compared. Resume feeding time, The length of hospitalization was significantly lower than that of the control group (P 0.01), and the incidence of anastomotic leakage in the observation group was 1.75) significantly lower than that in the control group, which was significantly lower than that in the control group (P < 7.01), and the incidence of anastomotic stenosis in the observation group was significantly lower than that in the control group (P < 0.01), and the difference was statistically significant. Scientific significance (P0. 04), 6 months and 1 year after operation. The Wexner score of the observation group was significantly lower than that of the control group (P 0.01), and the life style, psychological coping / behavior, depression and self-feeling of the observation group were significantly lower than those of the control group one year after operation. FIQL scores of embarrassment were significantly higher than those of control group (P 0.05). Conclusion prophylactic ileostomy can significantly reduce the complications such as anastomotic leakage after anus-preserving operation for low rectal cancer, promote the recovery of exhaust defecation function and shorten the hospital stay. And can effectively improve the quality of life, worthy of clinical promotion.
【作者单位】：贵州医科大学附属医院肛肠外科;
【分类号】：R735.37

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