保肛手術對低位直腸癌的治療效果及其安全性分析

黃超明

[摘要] 目的 探究保肛手術在低位直腸癌治療的效果和并發癥發生率。 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，依據隨機數字表方法劃分為觀察組和對照組，各25例，對照組患者采用經腹會陰聯合直腸癌根治術，觀察組患者采用保肛手術，對比兩組患者治療效果和并發癥發生率。結果 觀察組患者手術出血量（148.7±32.6）mL、手術時間（141.7±38.6）min、住院時間（7.1±1.2）d和術后排氣時間（2.3±0.7）d均明顯低于對照組患者，組間數據經比較差異有統計學意義（t=4.442，5.060，19.261，4.602，P<0.05）。觀察組直腸癌患者術后生活質量優良率92.00%顯著高于對照組64.00%，組間數據對比差異有統計學意義（χ2=5.711，P<0.05）。觀察組患者并發癥發生率為8.00%，對照組患者并發癥發生率為32.00%，組間數據比較差異有統計學意義（χ2=4.500，P<0.05）。 結論 保肛手術治療低位直腸癌效果良好，可改善患者的肛門功能，降低并發癥發生率，有利于提高患者生活質量，值得臨床推廣應用。

[關鍵詞] 保肛手術;低位直腸癌;排便能力;控便能力;并發癥

[中圖分類號] R735? ? ? ? ? [文獻標識碼] 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生嚴重威脅。此病主要表現為腹痛和黃疸等，如果未及時治療會威脅患者生命安全[1-2]。臨床過去選擇傳統開腹直腸癌腹部根治術予以治療，雖效果良好但會損傷盆腔自主神經，患者術后會產生排便困難和排尿困難，嚴重者會對自身性功能產生影響，降低患者生活質量[3-4]。目前，保肛手術廣泛應用于臨床中，將根治術轉變為兼顧全功能，可將患者的肛門功能予以保留，有助于患者病情緩解，改善其不良預后，手術方法優勢顯著[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，探究保肛手術在低位直腸癌治療的效果和并發癥發生率，現報道如下。