基于计划行为理论的康复护理对直肠癌保肛术后患者肛门直肠动力学和生活质量的影响  

Effect of rehabilitation nursing base on theory of planned behavior on anorectal dynamics and quality of life in rectal cancer patients after sphincter-preserving surgery for rectal cancer

作　　者：柏丹 周冬兵 范雨诗 李权林 喻晶 袁春艳 田婷 Bai Dan;Zhou Dongbing;Fan Yushi;Li Quanlin;Yu Jing;Yuan Chunyan;Tian Ting(Department of Gastrointestinal anorectal hernia surgery,Nanchong Central Hospital(the Second Clinical Hospital of North Sich-uan Medical University),Nanchong 637100,Sichuan,China)

机构地区：[1]南充市中心医院(川北医学院第二临床医院)胃肠肛肠疝外科,四川南充637100

出　　处：《结直肠肛门外科》2023年第4期401-407,共7页Journal of Colorectal & Anal Surgery

基　　金：四川省医学科研课题计划(S21082)。

摘　　要：目的探讨基于计划行为理论的康复护理对直肠癌保肛术后患者肛门直肠动力学和生活质量的影响。方法选取2021年1月至2021年12月于南充市中心医院(川北医学院第二临床医院)行低位直肠癌根治术的100例患者作为研究对象。按照随机数字表法分为对照组(采用常规术后护理)和观察组(采用基于计划行为理论的康复护理),每组各50例。剔除不符合要求的患者11例,最终共纳入89例患者(观察组46例,对照组43例)。对比两组肛肠动力学相关指标(肛管静息压、直肠静息压、肛管最大收缩压、直肠初始感觉容量、直肠便意感觉容量、直肠最大耐受容量)、低位前切除综合征发生率及生活质量。结果术前,两组肛管静息压、直肠静息压、肛管最大收缩压、直肠初始感觉容量、直肠便意感觉容量和直肠最大耐受容量比较差异均无统计学意义(均P>0.05);术后6个月,两组肛管静息压、直肠静息压和肛管最大收缩压均低于术前,直肠初始感觉容量、直肠便意感觉容量和直肠最大耐受容量均小于术前(均P<0.05),观察组肛管静息压、直肠静息压均低于对照组,肛管最大收缩压高于对照组,直肠初始感觉容量、直肠便意感觉容量和直肠最大耐受容量均大于对照组(均P<0.05)。术后6个月内,观察组有18例(39.1%)患者发生低位前切除综合征,对照组有28例(65.1%)患者发生低位前切除综合征,观察组低位前切除综合征发生率低于对照组(χ^(2)=6.010,P=0.014)。术前,两组功能维度、症状维度、总体健康状况维度和单项测量维度评分比较差异均无统计学意义(均P>0.05);术后6个月,两组功能维度、总体健康状况评分均高于术前,症状维度、单项测量维度评分均低于术前,且观察组功能维度、总体健康状况评分均高于对照组,症状维度、单项测量维度评分均低于对照组(均P<0.05)。结论直肠癌患者保肛术后实施基于计�Objectives To investigate the effect of rehabilitation nursing based on the theory of planned behavior on anorectal dynamics and quality of life in patients after sphincter-preserving surgery for rectal cancer.Methods A total of 100 patients who underwent radical resection of low rectal cancer at Nanchong Central Hospital(the Second Clinical Hospital of North Sich⁃uan Medical University)from January 2021 to December 2021 were selected.They were divided into control group(receiving con⁃ventional postoperative nursing)and observation group(receiving rehabilitation nursing based on the theory of planned behavior)according to a random number table,with 50 patients in each group.Eleven patients who did not meet the criteria were exclud⁃ed,leaving 89 patients(46 patients in the observation group and 43 patients in the control group).The indicators related to ano⁃rectal dynamics(anal canal resting pressure,rectal resting pressure,maximum anal canal contraction pressure,initial sensory vol⁃ume of rectum,volume of rectal urge sensation,maximum tolerable volume of rectum),the incidence of low anterior resection syn⁃drome,and quality of life were compared between the two groups.Results Before surgery,there were no significant differences in anal canal resting pressure,rectal resting pressure,maximum anal canal contraction pressure,initial sensory volume of rectum,volume of rectal urge sensation,and maximum tolerable volume of rectum between the two groups(P>0.05).Six months after sur⁃gery,both groups had lower anal canal resting pressure,rectal resting pressure,and maximum anal canal contraction pressure than preoperative levels,and lower initial sensory volume of rectum,volume of rectal urge sensation,and maximum tolerable volume of rectum than preoperative levels(P<0.05).The observation group had lower anal canal resting pressure and rectal resting pressure than the control group,and higher maximum anal canal contraction pressure than the control group.The observation group had higher initial sensory volume

关 键 词：直肠癌 保肛术 低位前切除综合征 肛门直肠动力学 计划行为理论 

分 类 号：R735.3[医药卫生—肿瘤]