摘要
目的探讨创伤后应激障碍对低位直肠癌保肛术后患者肛门功能的影响。方法本研究为前瞻性研究,纳入2019年1月至2022年6月郑州大学第二附属医院收治的76例低位直肠癌患者,所有患者均接受保肛术治疗,术后7 d采用创伤后应激障碍自评量表平民版评估患者创伤后应激障碍情况,将发生创伤后应激障碍的患者纳入研究组(24例),未发生创伤后应激障碍的患者纳入对照组(52例)。比较两组肛肠动力学指标(肛管最大收缩压、肛管静息压、直肠最大耐受容量、括约肌功能长度),分析创伤后应激障碍对肛门功能的影响。结果76例低位直肠癌患者中,有24例患者发生创伤后应激障碍,发生率为31.58%。研究组创伤后应激障碍自评量表评分为(58.25±3.66)分,高于对照组的(33.29±3.45)分,差异有统计学意义(P<0.05)。两组括约肌功能长度比较,差异无统计学意义(P>0.05);研究组肛管最大收缩压、肛管静息压及直肠最大耐受容量均低于对照组(P<0.05)。经Pearson相关性分析,创伤后应激障碍自评量表评分与肛管最大收缩压、肛管静息压、直肠最大耐受容量均呈负相关(r<0,P<0.05)。结论低位直肠癌保肛术后患者创伤后应激障碍会导致肛门功能障碍。
Objective To explore the effect of post-traumatic stress disorder on anal function in patients with low rectal cancer after anus preserving operation.Methods This study was a prospective study,involving 76 patients with low rectal cancer admitted to the Second Affiliated Hospital of Zhengzhou University from January 2019 to June 2022.All patients were treated with anus preserving operation.At 7 days after operation,the patients with post-traumatic stress disorder were evaluated with the post-traumatic stress disorder self-assessment scale civilian version.The patients with post-traumatic stress disorder were included in the study group(24 cases),and the patients without post-traumatic stress disorder were included in the control group(52 cases).The anorectal dynamic indexes(maximum anal systolic pressure,anal resting pressure,maximum rectal tolerance capacity,sphincter function length)of the two groups were compared,and the impact of post-traumatic stress disorder on anal function was analyzed.Results Post-traumatic stress disorder occurred in 24 of 76 patients with low rectal cancer,with an incidence of 31.58%.The score of the post-traumatic stress disorder self-rating scale in the study group(58.25±3.66)was higher than that in the control group(33.29±3.45),and the difference was statistically significant(P<0.05).There was no statistical difference in the functional length of sphincter between the two groups(P>0.05).The maximum anal systolic pressure,anal resting pressure and rectal maximum tolerance capacity in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that the score of the post-traumatic stress disorder self-assessment scale was negatively correlated with the maximum anal systolic pressure,anal resting pressure and rectal maximum tolerance capacity(r<0,P<0.05).Conclusion Post-traumatic stress disorder can lead to anal dysfunction in patients with low rectal cancer after anus preserving operation.
作者
宋利芳
陈静娜
李玉雪
SONG Lifang;CHEN Jingna;LI Yuxue(Department of General Surgery,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)
出处
《河南医学研究》
CAS
2023年第5期841-844,共4页
Henan Medical Research
关键词
低位直肠癌
保肛术
创伤后应激障碍
肛门功能
low rectal cancer
anus preserving operation
post-traumatic stress disorder
anal function
