直肠癌超低位吻合术后排便功能评价及康复护理.pdf

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1、88WESTCHINAMEDICALJOURNAL2007，Vo1.22，No.1CN51-1356/R［文章编号］1002-0179（2007）01-0088-03直肠癌超低位吻合术后排便功能评价及康复护理DefecationFunctionEvaluationandRehabilitateNursinginPost-operationofUltra-lowDixon陈增蓉，李卡，印义琼CHENZeng-rong，LlKa，YlNYi-giong（四川大学华西医院普外三科，四川成都610041）（DepartmentofGeneralSurgery，WestChinaHospital，Sic

2、huanUniuersity，Chengdu610041，China）摘要：目的：比较低位Dixon与超低位Dixon术后排便功能，指导低位直肠癌保肛术后患者肛门功能康复及护理。方法：对于纳入研究标准的541例低位直肠癌，保肛手术分为低位Dixon和超低位Dixon（吻合口距离齿状线!2cm）2组，两组性别、年龄、肿瘤距离齿状线距离、肉眼分类、肿瘤长径、侵犯肠管环周度、组织学分化程度、浸润深度、淋巴结转移站别、Dukes分期无统计学差异。术后3个月比较两组的肛门控制力、便意及排便感觉，用徐忠法的五项10分标准，用二项分类LogisticRegresssion分析性别、年龄、肿瘤部位及吻合口距离

3、齿状线距离等影响排便功能的有关因素。结果：超低位Dixon与低位Dixon比较肛门控制力没有明显差异，排便感觉和便意与低位Dixon比较，有统计学差异。二项分类LogisticRegresssion分析结果性别、年龄段、肿瘤部位、吻合口位置及淋巴结清扫范围是影响患者术后排便功能的因素。结论：超低位Dioxn手术后排便功能低于低位Dixon手术，排便感觉和便意需要进行康复训练。关键词：直肠癌；排便功能；护理［中图分类号］R735.3+7［文献标志码］AAbstract：Objective：Tocomparedefecationfunctionofpost-operationofiow-setDi

4、xonanduitra-iowDixonandguiderehabiiitationandnursingofanaifunctionofpatientaftersphincterpreserving（SP）operationforiowrectaicancer.Method：dataof541patientswithiowrectaicancer，SPoperationinciudingiow-setDixongroupanduitraiowDixongroup（anastomoticstomafromanocutaneousiine!2cm），thesetwogroupnodifferenc

5、einsex、age、tumordistancefromanastomoticstoma、ciassifica-tion、diameter、tumorcycie、histoiogydifferentiated、iymphnodemetastasis、Dukesstage.Comparingtobethmicforceofanus、awarenessofdedcationanddefecationfeeiingoftwogroupsafter3monthandanaiysisfactorofinfiuencefuntiondefecationofsex、age、tumoriocationandd

6、istancefromanastomoticstomathroughmethodofxuzhongandLogisticRegresssion.Resuit：Therewerenodifferenceinbethmicforceofanus，thereweresignificantdifferenceinawarenessoffefecationanddefecationfeeiing.LogisticRegresssionanaiysisshowsthatsex、age、tumoriocation、anastomoticstomaiocationandiymphnodefactorsinfi

7、uenc-ingdefecationfuctionpos-opofpatient.Conciusion：PatientsdefecationfunctionofuitraiowDixonoperationwasworsethaniowDixonoperation，rehabiiitationtrainingwasemphasizedinawarenessofdefecationandfeeiing