摘要
目的:比较末端回肠造口术与横结肠造口术治疗低位直肠癌腹腔镜保肛术患者的效果。方法:选取2020年1月至2022年10月该院收治的60例低位直肠癌患者进行前瞻性研究,采用随机数字表法将其分为对照组与研究组各30例。对照组采用横结肠造口术治疗,研究组采用末端回肠造口术治疗,比较两组手术相关指标水平、术后胃肠功能恢复时间、肛门失禁情况、排便优良率和造口相关并发症发生率。结果:两组出血量、手术时间比较,差异无统计学意义(P>0.05);研究组住院时间短于对照组,差异有统计学意义(P<0.05);研究组术后首次进食、排气、排便等胃肠功能恢复时间均短于对照组,差异有统计学意义(P<0.05);术后1、3、6个月,研究组Wexner评分均低于对照组,差异有统计学意义(P<0.05);两组排便优良率比较,差异无统计学意义(P>0.05);两组造口相关并发症发生率比较,差异无统计学意义(P>0.05)。结论:末端回肠造口术治疗低位直肠癌腹腔镜保肛术患者可改善手术相关指标水平,缩短胃肠功能恢复时间,降低Wexner评分,其效果优于横结肠造口术治疗。
Objective:To compare effects of terminal ileostomy and transverse colostomy in treatment of patients with low rectal cancer undergoing laparoscopic anus-preserving surgery.Methods:A prospective study was conducted on 60 patients with low rectal cancer admitted to this hospital from January 2020 to October 2022.They were divided into control group and study group by using the random number table method,30 cases in each group.The control group was treated with transverse colostomy,while the study group was treated with terminal ileostomy.The levels of operation-related indicators,the postoperative gastrointestinal function recovery time,the anal incontinence,the excellent and good rate of defecation,and the incidence of stoma-related complications were compared between the two groups.Results:There were no significant differences in the amount of bleeding and the operation time between the two groups(P>0.05).The hospitalization time of the study group was shorter than that of the control group,and the difference was statistically significant(P<0.05).The recovery time of gastrointestinal function such as first feeding,exhaust and defecation in the study group was shorter than that in the control group,and the difference was statistically significant(P<0.05).1,3 and 6 months after the surgery,the Wexner scores of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the excellent and good rate of defecation between the two groups(P>0.05).There was no significant difference in the incidence of stoma-related complications between the two groups(P>0.05).Conclusions:Terminal ileostomy in the treatment of the patients with low rectal cancer undergoing laparoscopic anus-preserving surgery can improve the levels of operation-related indicators,short the gastrointestinal function recovery time,and reduce and the Wexner scores.Moreover,it is superior to transverse colostomy.
作者
赵世辉
吴晓鹏
ZHAO Shihui;WU Xiaopeng(The First People’s Hospital of Ruzhou,Gastrointestinal Surgery,Ruzhou 467599 Henan,China;The First People’s Hospital of Ruzhou,Nursing Department,Ruzhou 467599 Henan,China)
出处
《中国民康医学》
2023年第19期144-146,150,共4页
Medical Journal of Chinese People’s Health
关键词
低位直肠癌
末端回肠造口术
横结肠造口术
腹腔镜保肛术
肛门失禁
胃肠功能
Low rectal cancer
Terminal ileostomy
Transverse colostomy
Laparoscopic anus-preserving surgery
Anal incontinence
Gastrointestinal function
