【摘要】：目的盆腔放射病(pelvic radiation disease,PRD)為放療后盆腔內(nèi)多器官、多部位損傷,患者在病變小腸切除術(shù)后存在便頻、便失禁等癥狀。直腸在盆腔放療中是最易受放射性損傷的部位,目前針對(duì)PRD患者肛管直腸功能的研究尚不充分。文中主要了解宮頸癌伴慢性PRD患者的肛管直腸功能,并為PRD的治療及預(yù)后判斷提供依據(jù)。方法收集2014年1月至2015年1月期間南京軍區(qū)南京總醫(yī)院普通外科住院患者,分別納入需行小腸切除術(shù)的宮頸癌伴PRD患者及健康對(duì)照者。健康對(duì)照者來自門診體檢人群。在排除了高血壓、糖尿病等全身性疾病及便秘、盆底失遲緩等消化系統(tǒng)疾病后分別入PRD組(n=20)和對(duì)照組(n=20),根據(jù)年齡進(jìn)行配對(duì)。所有受試者均完成腸鏡、肛門測(cè)壓。根據(jù)腸鏡結(jié)果評(píng)估放射性直腸黏膜損傷程度,比較2組間肛管直腸測(cè)壓結(jié)果。結(jié)果研究所納入的所有研究對(duì)象均無直腸狹窄、梗阻。PRD組的肛管靜息壓為(47.23±9.08)mm Hg,與對(duì)照組[(58.25±9.24)mm Hg]比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);肛管最大收縮壓PRD組為(75.92±30.15)mm Hg,與對(duì)照組[(146.50±18.76)mm Hg]比較,差異有統(tǒng)計(jì)學(xué)意義(P0.01);肛管舒張壓PRD組為(23.30±12.49)mm Hg,與對(duì)照組[(39.10±9.99)mm Hg]比較,差異有統(tǒng)計(jì)學(xué)意義(P0.01);直腸排便壓PRD組為(22.85±16,69)mm Hg,與對(duì)照組[(50.90±9.14)mm Hg]比較,差異有統(tǒng)計(jì)學(xué)意義(P0.01);直腸最大耐受量PRD組為(112.85±51.34)m L,與對(duì)照組[(173.50±48.15)m L]比較,差異有統(tǒng)計(jì)學(xué)意義(P0.01);2組在直腸初始閾值(P=0.416),直腸排便感覺閾值(P=0.161);括約肌功能長(zhǎng)度(P=0.313)方面差異均無統(tǒng)計(jì)學(xué)意義。結(jié)論宮頸癌伴PRD患者因放療致其肛門內(nèi)外括約肌功能受損,直腸最大耐受容量減少。腸道手術(shù)前需評(píng)估其肛管直腸的神經(jīng)與肌肉功能,以制定合適的手術(shù)方案,從而最大程度改善PRD患者術(shù)后的生活質(zhì)量。
[Abstract]:Objective pelvic radiation sickness (pelvic radiation disease,PRD) is a multiple organ and multiple site injury in the pelvis after radiotherapy. The patients have frequent stool and incontinence after resection of the diseased small intestine. Rectum is the most vulnerable site of radiation injury in pelvic radiotherapy. At present, the study of anorectal function in patients with PRD is not sufficient. In this paper, we mainly investigate the anorectal function of patients with cervical cancer with chronic PRD, and provide the basis for the treatment and prognosis of PRD. Methods from January 2014 to January 2015, the inpatients in general surgery of Nanjing General Hospital of Nanjing military region were included in cervical cancer with PRD and healthy controls. The healthy control group came from the outpatient medical examination population. After excluding hypertension, diabetes mellitus and other digestive system diseases such as constipation and pelvic floor retardation, PRD group (n 鈮，

本文編號(hào)：2514314