黃超明

[摘要] 目的 探究保肛手術(shù)在低位直腸癌治療的效果和并發(fā)癥發(fā)生率。 方法 選擇該院2016年1月—2018年8月期間收治的50例低位直腸癌患者，依據(jù)隨機(jī)數(shù)字表方法劃分為觀察組和對照組，各25例，對照組患者采用經(jīng)腹會陰聯(lián)合直腸癌根治術(shù)，觀察組患者采用保肛手術(shù)，對比兩組患者治療效果和并發(fā)癥發(fā)生率。結(jié)果 觀察組患者手術(shù)出血量（148.7±32.6）mL、手術(shù)時間（141.7±38.6）min、住院時間（7.1±1.2）d和術(shù)后排氣時間（2.3±0.7）d均明顯低于對照組患者，組間數(shù)據(jù)經(jīng)比較差異有統(tǒng)計(jì)學(xué)意義（t=4.442，5.060，19.261，4.602，P<0.05）。觀察組直腸癌患者術(shù)后生活質(zhì)量優(yōu)良率92.00%顯著高于對照組64.00%，組間數(shù)據(jù)對比差異有統(tǒng)計(jì)學(xué)意義（χ2=5.711，P<0.05）。觀察組患者并發(fā)癥發(fā)生率為8.00%，對照組患者并發(fā)癥發(fā)生率為32.00%，組間數(shù)據(jù)比較差異有統(tǒng)計(jì)學(xué)意義（χ2=4.500，P<0.05）。 結(jié)論 保肛手術(shù)治療低位直腸癌效果良好，可改善患者的肛門功能，降低并發(fā)癥發(fā)生率，有利于提高患者生活質(zhì)量，值得臨床推廣應(yīng)用。

[關(guān)鍵詞] 保肛手術(shù);低位直腸癌;排便能力;控便能力;并發(fā)癥

[中圖分類號] R735? ? ? ? ? [文獻(xiàn)標(biāo)識碼] A? ? ? ? ? [文章編號] 1674-0742（2019）05（b）-0051-03

[Abstract] Objective To investigate the effect of anal sphincter preservation in the treatment of low rectal cancer and the incidence of complications. Methods 50 patients with low rectal cancer admitted to our hospital from January 2016 to August 2018 were convenient enrolled in the observation group and the control group according to the random number table method， 25 cases in each group. The control group was treated with transabdominal perineal combined with rectum radical radical surgery， the anal sphincter preservation was performed in the observation group， and the treatment effect and complication rate were compared between the two groups. Results The amount of surgical bleeding （148.7±32.6）mL， operation time （141.7±38.6） min， hospitalization time （7.1±1.2）d and postoperative exhaust time （2.3±0.7）d were significantly lower in the observation group than in the control group. The difference between the patients and the data was statistically significant （t=4.442， 5.060， 19.261， 4.602， P<0.05）. The excellent quality of life of patients with rectal cancer in the observation group was 92.00%， which was significantly higher than that in the control group （64.00%）. The difference between the two groups was statistically significant （χ2=5.711， P<0.05）. The complication rate was 8.00% in the observation group and 32.00% in the control group. The difference between the groups was statistically significant （χ2=4.500， P<0.05）. Conclusion Anal sphincter surgery is effective in treating low rectal cancer， which can improve the anal function of patients， reduce the incidence of complications， and improve the quality of life of patients. It is worthy of clinical application.

[Key words] Anal sphincter preservation; Low rectal cancer; Defecation ability; Control ability; Complications

低位直腸癌屬于胃腸道惡性腫瘤，死亡率較高，對患者的生命健康產(chǎn)生嚴(yán)重威脅。此病主要表現(xiàn)為腹痛和黃疸等，如果未及時治療會威脅患者生命安全[1-2]。臨床過去選擇傳統(tǒng)開腹直腸癌腹部根治術(shù)予以治療，雖效果良好但會損傷盆腔自主神經(jīng)，患者術(shù)后會產(chǎn)生排便困難和排尿困難，嚴(yán)重者會對自身性功能產(chǎn)生影響，降低患者生活質(zhì)量[3-4]。目前，保肛手術(shù)廣泛應(yīng)用于臨床中，將根治術(shù)轉(zhuǎn)變?yōu)榧骖櫲δ?，可將患者的肛門功能予以保留，有助于患者病情緩解，改善其不良預(yù)后，手術(shù)方法優(yōu)勢顯著[5]。該次研究方便選取該院2016年1月—2018年8月期間收治的50例低位直腸癌患者，探究保肛手術(shù)在低位直腸癌治療的效果和并發(fā)癥發(fā)生率，現(xiàn)報(bào)道如下。