直肠癌术前短程放疗后手术间隔期差异对会阴部切口愈合的影响  

Impact of the surgery interval after short course preoperative radiotherapy of rectal cancer on perineal wound healing

作　　者：王斌[1] 李增军[1] 徐忠法[1] 孙燕来[1] 公维鹏[1] 郭洪亮[1] 柴杰[1] 韩建军[1] 

机构地区：[1]山东省肿瘤医院胃肠外科,济南250117

出　　处：《山东大学学报（医学版）》2013年第4期92-95,共4页Journal of Shandong University:Health Sciences

基　　金：山东省医药卫生科技发展项目(2011HW069)

摘　　要：目的探讨直肠癌术前短程放疗后手术间隔时间的差异对会阴部切口愈合的影响。方法选取在山东省肿瘤医院2008年12月至2011年12月期间住院治疗的128例局部进展期低位直肠癌患者,并根据患者意愿,将128例患者分成3组:30例为直接手术组;55例行术前短程放疗(25 Gy,5×5 Gy),治疗完成后1周内行手术治疗,设为1周手术组;43例行术前短程放疗(25 Gy,5×5 Gy),治疗完成后4周行手术治疗,设为4周手术组。结果会阴部切口甲级愈合46例,乙级愈合52例,丙级愈合30例。直接手术组和4周手术组的丙级愈合发生率分别为6%和14%,差异无统计学意义(P>0.05)。1周手术组和4周手术组相比,丙级愈合发生率分别为40%和14%,差异有统计学意义(P<0.01)。经多因素分析,术前短程放化疗后手术间隔期的选择是影响会阴部切口愈合的独立因素。结论适当延长直肠癌术前短程放疗后的手术间隔期可明显地降低术后会阴部切口延迟愈合发生率。Objective To evaluate the impact of the surgery interval after short course preoperative radiotherapy of rec- tal cancer on the perineal wound healing. Methods 128 patients with local advanced lower rectal cancer treated in Shandong Tumor Hospital from December 2008 to December 2011 were selected and divided into three groups according to the wishes of the patients： patients（n =30） who underwent surgery （the first group） ; patients （n =55） who under- went surgery within 1 week of the short course preoperative radiotherapy （ 25 Gy, 5 Gy x 5 fracions ） （ the second group） ; patients （n =43 ） who underwent surgery after 4 weeks of the short course preoperative radiotherapy（ 25 Gy, 5 Gy x 5 fracions） （the third group）. Results The wound healing after APR was good in 46, moderate in 52, and poor in 30 patients. The incidence of poor wound healing of the first group and the third group were 6% and 14% re- spectively, and there was no significant difference （ P = 0. 549 ）. The incidence of poor wound healing of the second group and the third group were 40% and 14% respectively, and the difference was statistically significant（ P 〈 0.01 ）. Conclusion The prolongation of the time interval between short course preoperative and surgery can decrease the inci- dence rate of perineal wound delay healing for lower rectal cancer.

关 键 词：直肠肿瘤 经腹会阴联合直肠切除术 术前短程放疗 切口愈合 

分 类 号：R735.37[医药卫生—肿瘤]