摘要
目的：探讨吻合口位置对低位直肠癌患者保肛术后肛门功能恢复的影响。方法选择120例低位直肠癌保肛手术患者为研究对象。根据吻合口位置距肛缘的距离将患者分为3组：A组距离≤3．0 cm，B组距离＞3．0～5．0 cm，C组距离＞5．0 cm。选择60例非直肠癌患者为对照组，比较各组患者术后肛门功能的改变。结果肛管缩榨压、平均静息压及最大静息压，术后3个月A组、B组及C组均显著低于术前（P＜0．05）；但术后6个月比术后3个月显著提高（P＜0．05）；术后1年B组及C组各项指标接近术前（P＞0．05），但A组平均静息压及最大静息压仍显著低于术前（P＜0．05）。术后3个月、6个月及1年A组、B组及C组Wexner评分逐渐降低（P＜0．05），且组间差异有统计学意义（P＜0．05）。A组、B组及C组吻合口瘘发生率依次降低（P＜0．05）。结论低位直肠癌患者保肛术吻合口位置与患者术后肛门功能恢复关系密切，肛缘距离吻合口位置超过5 cm者术后肛门功能恢复最为理想。
Objective To explore the influence of location of stoma on the recovery of anal function in the low rectal cancer patients treated with anal sphincter preservation .Methods 120 low rectal cancer patients who received anal sphincter preservation were selected as the research subjects .The patients were divided into 3 groups according to location of stoma ,the dis-tance from stoma location to anal edge：group A：the distance ≤3.0 cm,group B：3.0cm〈distance≤5.0 cm,group C：distance〉5.0 cm.60 patients without rectal cancer was the control group .The changes of postoperative anal function were compared a-mong the groups .Results The maximal squeezing pressure of anus , resting anal pressures and the maximal anal pressure 3 months after operation in group A ,B and C all dropped significantly （P〈0.05）,while the above indexes gradually increased 6 months after operation （ P〈0.05）;There were no significant difference of the above indexes in group B and C before surgery and 1 year after operation （P〉0.05）,but the resting anal pressures and the maximal anal pressure in group A were much lower than before surgery （P〈0.05）;Wexner scores greatly decreased 3,6 months and 1 year after operation （P〈0.05） and had signifi-cant difference among group A,group B and group C（P〈0.05）;The occurrence of anastomotic leakage gradually decreased in group A,group B and group C（P〈0.05）.Conclusion Location of stoma is closely related with the recovery of anal function in the low rectal cancer patients who received anal sphincter preservation .The distance from stoma location to anal edge 〉5 cm has ideal effect on the recovery of anal function .
出处
《实用癌症杂志》
2014年第4期480-482,共3页
The Practical Journal of Cancer
关键词
低位直肠癌
吻合口
保肛术
肛门功能
Low rectal cancer
Anastomosis
Anal sphincter preservation
Anal function
