括约肌间切除术与人工肛门重建对低位直肠癌根治术患者术后生活质量的影响  

Effects of patients’postoperative quality of life between intersphincteric resection(ISR)and artificial anus surgery for low rectal cancer

作　　者：石守森 杨阳[2] 黄珂 王思远 胡怡娜 徐世友 李明[2] 魏东[2] SHI Shou-sen;YANG Yang;HUANG Ke;WANG Si-yuan;HU Yi-na;XU Shi-you;LI Ming;WEI Dong(Department of Gastrointestinal Surgery,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,China;Department of Colorectal Surgery,The 989 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force,Luoyang 471000,China)

机构地区：[1]郑州大学附属洛阳中心医院胃肠外科,河南洛阳471000 [2]中国人民解放军联勤保障部队第989医院结直肠外科,河南洛阳471000

出　　处：《中国现代普通外科进展》2022年第2期128-131,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:对比低位直肠癌根治术患者行括约肌间切除术(ISR)、人工肛门重建术后生活质量的差别。方法:对2015年1月至2019年6月70例低位直肠癌根治术患者进行EORTC的QLQ-C3O和QLQ-CR38问卷调查。其中42例患者行ISR(ISR组),28例患者行人工肛门重建(人工肛门重建组)。结果:QLQ-C30问卷结果显示,ISR组总体生活质量得分明显高于人工肛门重建组(73.41 vs 63.39,P=0.03);在社会功能方面,人工肛门重建组优于ISR组(78.57 vs 66.67,P=0.03);人工肛门重建组失眠、腹泻、疼痛、经济问题等出现概率较ISR组明显升高(P<0.05),而在其他功能、症状领域两组比较差异均无统计学意义(P>0.05)。QLQ-CR38相关领域内两组指标比较差异无统计学意义(P>0.05)。结论:对于低位直肠癌根治术患者,总体生活质量上ISR更优,社会功能方面人工肛门重建更佳。Objective:To compare the quality of life between patients undergoing intersphincteric resection(ISR)and artificial anus surgery for low rectal cancer.Method:A total of 70 patients with low rectal cancer undergoing radical resection from January 2015 to June 2019 were investigated by EORTC QLQ-C3O and QLQ-CR38 questionnaire.42 patients underwent ISR(ISR group)and 28 patients underwent artificial anal reconstruction(artificial anal reconstruction group).Results:According to the results of the QLQ-C30 analysis,we concluded that global health status(P=0.03)were better in the ISR group patients than in the artificial anus surgery group patients.Social functioning was superior in patients in the artificial anus surgery group compared with patients in the ISR group(P=0.03).In terms of financial impact,pain,diarrhea,and sleep disturbance,the scores of the patients in the ISR group was far higher than that of patients in the artificial anus surgery group(P<0.05).No significant differences were observed in other symptom and function domains.No significant differences were observed among the three groups in the related domains according to the QLQ-CR38 scale.Conclusion:We concluded that overall quality of life was better in the ISR group patients than in the artificial anus surgery group patients.Social functioning was superior in patients in the artificial anus surgery group compared with patients in the ISR groups.

关 键 词：低位直肠癌 人工肛门重建 经括约肌间切除术 生活质量 

分 类 号：R735.37[医药卫生—肿瘤]