摘要
目的评价采用J型贮袋在高龄患者保肛手术后改善排便机能中的价值。方法选取2002年2月至2003年8月诊治的39例高龄(≥75岁)低位直肠癌患者。按手术方式分成两组,传统的结肠断端与直肠肛管直接端端吻合组(直吻组),结肠J型贮袋与直肠肛管行端侧吻合组(贮袋组),对保肛手术后控便情况进行调查研究。结果术后排便次数正常的时间:贮袋组优于直吻组(P<0.01)。术后3个月、半年,贮袋组平均排便次数明显少于直吻组(P<0.05);延缓排便控制能力、失禁综合评分、区分排便排气能力等指标均优于直吻组(P<0.05);但术后1年及1年半,两组控便能力差异无显著性(P>0.05)。贮袋组直肠测压值优于直吻组。术后控便情况满意率贮袋组高于直吻组。采用贮袋吻合术后便秘的发生率高于直接吻合术(P<0.01)。结论(1)高龄不是结肠贮袋直肠肛管吻合术的禁忌证;(2)采用结肠贮袋直肠肛管吻合术能够明显改善高龄患者术后1年内控便功能。
Objective To evaluate the bowel control effect of J-pouch coloanal anastomosis of the anus-retained operation in elderly low rectal cancer patients. Methods Thirty-nine elderly low rectal cancer inpatients（≥75 years） in our hospital from Feb. 2002 to Aug. 2003 were included. They were divided into direct anastomosis group and colonic J-pouch anastomosis group. The bowel control effect of patients were investigated. Results The colonic J- pouch anastomosis group had improved defecation recovery time compared with that in the direct anastomosis group after surgery（P〈0.01）. Compared with direct anastomonsis group, patients with colonic J-pouch anastomosis displayed significantly better bowel control after 3 months or half year（P〈0.05）, but did not display significant difference after 1 year（P〉0.05）. Patients in the colonic J-pouch anastomosis group had better rectal pressure and higher satisfaction rate but had higher rate of constipation than that in the direct anastomosis group after operation. Conclusion （1） Advanced age （≥75 years） should not be the contraindication of colonic J-pouchanal anastomosis. （2） For these patients using the colonic J-pouchanal anastomosis can improve bowel control function obviously within 1 year.
出处
《中华老年多器官疾病杂志》
2008年第3期182-185,189,共5页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
低位直肠癌
保肛手术
结肠J型贮袋
年龄因素
low rectal cancer
anus-retained operation
colonic J-pouchanal anastomosis
age factor
