保肛手术对低位直肠癌的治疗效果及其安全性分析

黄超明

[摘要] 目的 探究保肛手术在低位直肠癌治疗的效果和并发症发生率。 方法 选择该院2016年1月—2018年8月期间收治的50例低位直肠癌患者，依据随机数字表方法划分为观察组和对照组，各25例，对照组患者采用经腹会阴联合直肠癌根治术，观察组患者采用保肛手术，对比两组患者治疗效果和并发症发生率。结果 观察组患者手术出血量（148.7±32.6）mL、手术时间（141.7±38.6）min、住院时间（7.1±1.2）d和术后排气时间（2.3±0.7）d均明显低于对照组患者，组间数据经比较差异有统计学意义（t=4.442，5.060，19.261，4.602，P<0.05）。观察组直肠癌患者术后生活质量优良率92.00%显著高于对照组64.00%，组间数据对比差异有统计学意义（χ2=5.711，P<0.05）。观察组患者并发症发生率为8.00%，对照组患者并发症发生率为32.00%，组间数据比较差异有统计学意义（χ2=4.500，P<0.05）。 结论 保肛手术治疗低位直肠癌效果良好，可改善患者的肛门功能，降低并发症发生率，有利于提高患者生活质量，值得临床推广应用。

[关键词] 保肛手术;低位直肠癌;排便能力;控便能力;并发症

[中图分类号] R735          [文献标识码] A          [文章编号] 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

低位直腸癌属于胃肠道恶性肿瘤，死亡率较高，对患者的生命健康产生严重威胁。此病主要表现为腹痛和黄疸等，如果未及时治疗会威胁患者生命安全[1-2]。临床过去选择传统开腹直肠癌腹部根治术予以治疗，虽效果良好但会损伤盆腔自主神经，患者术后会产生排便困难和排尿困难，严重者会对自身性功能产生影响，降低患者生活质量[3-4]。目前，保肛手术广泛应用于临床中，将根治术转变为兼顾全功能，可将患者的肛门功能予以保留，有助于患者病情缓解，改善其不良预后，手术方法优势显著[5]。该次研究方便选取该院2016年1月—2018年8月期间收治的50例低位直肠癌患者，探究保肛手术在低位直肠癌治疗的效果和并发症发生率，现报道如下。