摘要
目的了解目前直肠癌术后低位前切除综合征(LARS)的评估方法以及治疗进展。方法复习近年来关于直肠癌术后LARS相关研究的文献并加以综述。结果 LARS的发生机制与手术前肛门功能状态、手术中对肛门直肠周围神经、肌肉损伤以及新建直肠容积、顺应性等均有密切关系。针对LARS的症状群,临床现有主观、客观等多种评估办法,包括多种生活质量评分量表、大便失禁相关量表、LARS评分量表、肛管直肠测压、肛门括约肌影像学检查等手段。治疗包括经肛门灌洗、综合康复训练、骶神经刺激、中医疗法等多种治疗方法。结论术前、术中、术后多重因素影响LARS的发生,详尽的评估、规范的手术及治疗以及有效的患者教育都可以预防或减轻LARS,提升患者术后生活质量。
Objective To understand the current evaluation methods and treatment progress of low anterior resection syndrome(LARS) after rectal cancer surgery. Method The recent literatures on the progress of LARS studies were reviewed. Results The occurrence mechanism of LARS was closely related to the function state of anus before operation,the nerve and muscle injuries around the anus and rectum during the operation,as well as the new rectal volume and compliance. For this symptom group,there were various clinical evaluation methods,including the various quality of life score scales,fecal incontinence related scales,LARS score scale,anorectal pressure measurement,and imaging examination of anal sphincter,etc. The treatment included the anal lavage,comprehensive rehabilitation training,sacral nerve stimulation,traditional Chinese medicine therapy,and other treatment methods. Conclusion LARS might be prevented or alleviated through accurately preoperative evaluation,standardized and reasonable surgery and adjuvant therapy,and effective postoperative intervention.
作者
蒋伟
官海迪
邱远
杨桦
肖卫东
JIANG Wei;GUAN Haidi;QIU Yuan;YANG Hua;XIAO Weidong(No.3 Group,Basic Medical College of Air Force Military Medical University,Xi’an 710068,P.R.China;Department of General Surgery,The Second Affiliated Hospital of Army Medical University,Chongqing 400037,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2020年第5期624-628,共5页
Chinese Journal of Bases and Clinics In General Surgery
基金
重庆市科卫联合医疗科研项目(项目编号:2019QNXM019)。
关键词
直肠癌
低位前切除综合征
评估
治疗
rectal cancer
anterior low resection syndrome
assessment
treatment
