摘要
目的观察直肠癌内括约肌切除保肛术在低位直肠癌治疗中的疗效。方法选择2014年12月至2016年6月于本院接受直肠癌内括约肌切除保肛术的48例低位直肠癌患者作为观察组,选择同期50例健康人群作为对照组,比较术前两组的肛门功能和生活质量状况(SF-36),分析观察组手术前后的肛门功能及生活质量状况。结果术前两组的肛门功能优良率相比差异无统计学意义(P>0.05);观察组术后3、6、12个月的肛门功能优良率均显著低于术前(P<0.05),术后12个月的优良率显著高于术后3个月(P<0.05)。术前两组的肛门直肠静息压(ARP)、最大缩榨压(MSP)、肛门直肠抑制反射(RAIA)及最大耐受容量(MTV)相比差异无统计学意义(P>0.05);与术前相比,观察组术后3、6、12个月的上述指标均显著降低(P<0.05)。观察组术后12个月的ARP、MSP、RAIA、MTV均显著高于术后3、6个月(P<0.05)。术前两组的生活质量评估相比差异无统计学意义(P>0.05);生活质量评估结果显示,观察组术后3、6、12个月的生理功能(physical function,PF)和生理职能(role-physical,RP)均显著低于术前(P<0.05)。结论对低位直肠癌患者施行直肠癌内括约肌切除保肛术可有效保障患者生活质量,虽对术后不同时点的肛门功能造成不同程度的损伤,但肛门功能的呈良性恢复趋势。
Objective To investigate the effect of anus-preserving operation with resection of internal sphincter for the treatment of low rectal cancer. Methods From June 2014 to December 2015, a total of 48 patients with rectal cancer were recruited as treatment group, and a total of 50 healthy subjects from the Medical Examination Center and Clinic of our hospital were recruited as control group. The anal function and quality of life were measured with Xu Zhongfa anal evaluation criteria, anorectal manometry and the SF-36. Results The ratings of excellent and good for anus functions at 3 month, 6 month and 12 month after operation in treatment group were significantly lower than that of pre-operation（P 〈 0.05）, the ARP, MSP, RAIA, MTV of treatment group all significantly decreased at 3 month, 6 month and 12 month after operation（P 〈 0.05）. SF-36 showed that the scores of physical function and rolephysical domain were lower than that of the healthy controls（P 〈0.05）. Conclusion Anus-preserving surgery is suitable for patients with rectal cancer.
出处
《结直肠肛门外科》
2017年第1期31-35,共5页
Journal of Colorectal & Anal Surgery
关键词
直肠癌内括约肌切除保肛术
肛门功能
生活质量
anus-preserving operation with resection of internal sphincter
anal function
quality of life
