经肛门灌洗对直肠癌患者低前切除术综合征的治疗作用  

Effect of transanal irrigation on the treatment of low anterior resection syndrome in patients with rectal cancer

作　　者：马旭 李青科[2] 何立芳 MA Xu;LI Qingke;HE Lifang(Department of Surgical Oncology,Tangshang People's Hospital,Hebei Tangshan 063000,China;Department of Gastrointestinal Surgery,Tangshang People's Hospital,Hebei Tangshan 063000,China;Department of Renal Medicine,Tangshang People's Hospital,Hebei Tangshan 063000,China)

机构地区：[1]唐山市人民医院肿瘤外科,河北唐山063000 [2]唐山市人民医院胃肠外科,河北唐山063000 [3]唐山市人民医院肾内科,河北唐山063000

出　　处：《现代肿瘤医学》2022年第8期1416-1420,共5页Journal of Modern Oncology

摘　　要：目的:评估经肛门灌洗(transanal irrigation,TAI)在治疗低前切除术综合征(low anterior resection syndrome,LARS)中的作用及其对患者生活质量的影响。方法:纳入2018年5月-2019年2月在本院行低位直肠癌前切除术的78例患者。依据随机数字表法将患者分为TAI组和对照组,每组39例。TAI组使用了Peristeen^(TM)系统进行灌洗,对照组采用常规护理,两组共干预6个月。在干预开始前和结束后,评估患者LARS评分、纪念斯隆-凯特林癌症中心肠道功能问卷(MSKCC BFI)和生活质量评价量表(SF-36)。结果:TAI组有38例,对照组36例患者完成了整个研究过程。两组受试者的人口学和病情资料差异无统计学意义(P>0.05)。与对照组相比较,TAI组干预结束后LARS评分和MSKCC BFI评分的各个维度及其总分差异均有统计学意义(P<0.001);与干预前比较,TAI组干预后的LARS评分和MSKCC BFI评分的各维度及其总分差异均有统计学意义(P<0.001),而对照组干预前后的两项评分差异均没有统计学意义(P>0.05)。干预结束后两组受试者SF-36量表的躯体疼痛、社会功能、精神健康和情感职能4个维度得分差异有统计学意义(P<0.05),同样,TAI组干预前后这4个维度的评分差异也有统计学意义(P<0.05),而对照组SF-36量表所有维度在治疗前后差异均无统计学意义(P>0.05)。结论:TAI是可以有效改善LARS患者的LARS评分、MSKCC BFI评分和生活质量,有进一步研究和推广的价值。Objective:To evaluate the role of transanal irrigation(TAI)in the treatment of LARS and its impact on patients'quality of life.Methods:78 patients who underwent anterior resection of low rectal cancer in our hospital from May 2018 to February 2019 were enrolled.According to the random number table method,39 cases were divided into TAI group and control group.Peristeen^(TM) system was used for TAI in the TAI group and routine care in the control group.Before and after the intervention,patients were assessed with LARS score,the Memorial Sloan-Kettering Cancer Center Bowel Function Instrument(MSKCC BFI),and Short Form 36 Health Survey Questionnaire(SF-36).Results:38 patients in the TAI group and 36 in the control group completed the study.There was no statistically significant difference in demographic and disease data between the two groups(P>0.05).Compared with the control group,the LARS score and the MSKCC BFI score in TAI group after the intervention had statistically significant differences in all each dimension and their total scores(P<0.001).Compared with pre-intervention,the LARS score and MSKCC BFI score in TAI group after intervention had statistically significant differences in all dimensions and their total scores(P<0.001),while the difference between the two scores before and after intervention in the control group was not statistically significant(P>0.05).In the two groups after the intervention of SF-36 scale on the body pain,social function,mental health and emotional functions,difference was statistically significant(P<0.05).similarly,TAI group before and after the intervention in the four dimensions of score difference have statistical significance(P<0.05),while the control group SF-36 scale all dimensions in both before and after treatment differences had no statistical significance(P>0.05).Conclusion:TAI can effectively improve LARS score,MSKCC BFI score and quality of life in LARS patients,which is worth further research and promotion.

关 键 词：低前切除术综合征 经肛门灌洗 直肠癌 

分 类 号：R735.3[医药卫生—肿瘤]