摘要
目的探讨保肛术与腹会阴联合直肠癌根治造瘘术(Miles)治疗老年低位直肠癌患者的临床效果。方法选择我院2015年1月至2017年12月收治的老年低位直肠癌患者66例分为两组各33例。对照组采用Miles治疗,观察组采用保肛术。观察两组患者的围手术期指标(手术时间、术中出血量、术后排便时间、首次排气时间、住院时间)、生活质量评分(身体功能、心理状态、健康情况和生活能力)、盆腔复发率、吻合口复发率及术后1年总生存率(OS)。结果两组患者的手术时间比较无统计学差异(P>0.05)。观察组的术中出血量、术后排便时间、首次排气时间和住院时间均少于对照组(P <0.05)。观察组治疗后的身体功能、心理状态、健康情况和生活能力评分显著高于对照组(P <0.05)。观察组的盆腔复发率和吻合口复发率均低于对照组(P <0.05)。观察组的术后1年OS高于对照组(P <0.05)。结论与Miles比较,保肛术治疗老年低位直肠癌患者可有效提高临床效果,加快患者的术后恢复进程,改善其预后情况和生活质量,且术后并发症较少。
Objective To explore the clinical effect of anus preserving operation and abdominoperineal rectal cancer radical colostomy(Miles) in the treatment of elderly patients with low rectal cancer. Methods 66 cases of elderly patients with low rectal cancer admitted to our our hospital from January 2015 to December 2017 were selected and divided into two groups, with 33 cases in each group.The control group was treated with Miles, while the observation group received anus preserving operation. The perioperative indicators(operation time, intraoperative blood loss, postoperative defecation time, first exhaust time, hospitalization time), quality of life scores(physical function, mental state, health condition and life ability), pelvic recurrence rates, anastomotic stoma recurrence rates and 1-year overall survival rates(OS) of the two groups were observed. Results No statistical difference was found in the operation time between the two groups(P >0.05). The intraoperative blood loss, postoperative defecation time, first exhaust time and hospitalization time of the observation group were less than those of the control group(P <0.05). The scores of physical function, mental state, health condition and life ability in the observation group were significantly higher than those in the control group(P <0.05). The pelvic recurrence rate and anastomotic stoma recurrence rate of the observation group were lower than those of the control group(P <0.05). The 1-year OS of the observation group was higher than that of the control group(P <0.05). Conclusions Compared with Miles, anus preserving operation in the treatment of elderly patients with low rectal cancer can effectively improve the clinical efficacy, accelerate the postoperative recovery process, and improve the prognosis and quality of life of patients, with fewer postoperative complications.
作者
李维
韦万程
胡自康
LI Wei;WEI Wancheng;HU Zikang(Department of Anorectal Hemorrhoids,Gaozhou People's Hospital,Gaozhou 525200,China)
出处
《临床医学工程》
2019年第11期1543-1544,共2页
Clinical Medicine & Engineering
