本文關(guān)鍵詞： 低位直腸癌保肛術(shù) 回腸造口 低位直腸癌 臨床療效　出處：《廣東醫(yī)學(xué)》2017年07期 　論文類型：期刊論文

【摘要】：目的研究低位直腸癌保肛術(shù)聯(lián)合回腸造口治療低位直腸癌的臨床療效。方法選取低位直腸癌114例,采用隨機(jī)數(shù)字法將其分為對(duì)照組和觀察組,每組各57例。對(duì)照組患者僅接受低位直腸癌保肛術(shù)治療,觀察組患者在對(duì)照組基礎(chǔ)上聯(lián)合回腸造口治療。比較兩組患者的恢復(fù)排氣排便時(shí)間、恢復(fù)進(jìn)食時(shí)間、住院時(shí)間,同時(shí)比較吻合口瘺、吻合口狹窄等并發(fā)癥發(fā)生率,同時(shí)比較術(shù)前、術(shù)后6個(gè)月及1年的Wexner評(píng)分和術(shù)后1年的大小便失禁生活質(zhì)量問卷(FIQL)評(píng)分。結(jié)果觀察組的恢復(fù)排氣排便時(shí)間、恢復(fù)進(jìn)食時(shí)間、住院時(shí)間均明顯低于對(duì)照組(P0.01),觀察組的吻合口瘺發(fā)生率(1.75%)明顯低于對(duì)照組(15.79%),差異有統(tǒng)計(jì)學(xué)意義(醊2=7.01,P=0.00);觀察組的吻合口狹窄發(fā)生率(1.75%)明顯低于對(duì)照組(10.53%),差異有統(tǒng)計(jì)學(xué)意義(醊2=4.13,P=0.04);手術(shù)后6個(gè)月和1年,觀察組的Wexner評(píng)分均明顯低于對(duì)照組(P0.01);手術(shù)后1年,觀察組的生活方式、心理應(yīng)付/行為、抑郁/自我感受、窘迫尷尬等FIQL評(píng)分均明顯高于對(duì)照組(P0.05)。結(jié)論預(yù)防性回腸造口能明顯降低低位直腸癌保肛術(shù)術(shù)后吻合口瘺等并發(fā)癥,促進(jìn)患者排氣排便功能恢復(fù),縮短住院時(shí)間,并能有效提高生活質(zhì)量,值得在臨床推廣。
[Abstract]:Objective to study the clinical effect of anus-preserving operation combined with ileostomy in the treatment of low rectal cancer. Methods 114 cases of low rectal cancer were randomly divided into two groups: control group and observation group. There were 57 cases in each group. The patients in the control group were only treated with anus-preserving surgery for low rectal cancer, while the patients in the observation group were treated with ileostomy on the basis of the control group. The recovery time of exhaust defecation, the time of food recovery, and the time of hospitalization were compared between the two groups. At the same time, the incidence of anastomotic leakage, anastomotic stenosis and other complications were compared. The Wexner score before operation, 6 months and 1 year after operation, and the quality of life questionnaire (FIQL) score of incontinence and urinal incontinence 1 year after operation were compared. Results the time of recovery of exhaust and defecation in the observation group was compared. Resume feeding time, The length of hospitalization was significantly lower than that of the control group (P 0.01), and the incidence of anastomotic leakage in the observation group was 1.75) significantly lower than that in the control group, which was significantly lower than that in the control group (P < 7.01), and the incidence of anastomotic stenosis in the observation group was significantly lower than that in the control group (P < 0.01), and the difference was statistically significant. Scientific significance (P0. 04), 6 months and 1 year after operation. The Wexner score of the observation group was significantly lower than that of the control group (P 0.01), and the life style, psychological coping / behavior, depression and self-feeling of the observation group were significantly lower than those of the control group one year after operation. FIQL scores of embarrassment were significantly higher than those of control group (P 0.05). Conclusion prophylactic ileostomy can significantly reduce the complications such as anastomotic leakage after anus-preserving operation for low rectal cancer, promote the recovery of exhaust defecation function and shorten the hospital stay. And can effectively improve the quality of life, worthy of clinical promotion.
【作者單位】： 貴州醫(yī)科大學(xué)附屬醫(yī)院肛腸外科;
【分類號(hào)】：R735.37

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