低位直肠癌结肠腹壁造瘘与人工肛门重建术后生活质量对比  

Comparison of postoperative quality of life between definitive colostomy and perineal colostomy for low rectal cancer

作　　者：石守森 黄珂 胡怡娜 王思远 许震 李朝辉 SHI Shou-sen;HUANG Ke;HU Yi-na;WANG Si-yuan;XU Zhen;LI Zhao-hui(Department of Gastrointestinal Surgery,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,China;Department of Endocrinology,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,China;Department of Anorectal Surgery,the 989 Hospital of The Joint Logistics Support Force of PLA,Luoyang 471003,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]郑州大学附属洛阳中心医院内分泌科,河南洛阳471000 [3]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471003

出　　处：《中国现代普通外科进展》2024年第3期191-194,共4页Chinese Journal of Current Advances in General Surgery

基　　金：河南省医学科技攻关联合共建基金(LHGJ20220940)。

摘　　要：目的:对比低位直肠癌患者在接受经腹会阴直肠癌根治术后结肠腹壁造瘘与人工肛门重建的生活质量差别。方法:对2015年1月-2019年6月超低位直肠癌患者接受经腹会阴直肠癌根治术后行结肠造瘘或人工肛门重建的患者79例进行欧洲癌症治疗研究组织(EORTC)的癌症患者核心量表(QLQ-C30)和癌症特异性生活量表(QLQ-CR38)问卷调查。其中51例行结肠腹壁造瘘术(DC组),28例行人工肛门重建(PC组)。结果:根据QLQ-C30分析结果可以得出,在社会功能方面PC组优于DC组(P<0.05);在疲劳程度方面PC组患者的得分为29.36分,远低于DC组(39.65分,P<0.05)。在腹泻、经济问题方面PC组的得分高于DC组,而在其他的功能、症状领域差异均无统计学意义(P>0.05)。QLQ-CR38的相关领域内两组之间差异均无统计学意义(P>0.05)。结论:针对两种术式术后生活质量做对比,在总的生活质量方面相近,对于超低位直肠癌经腹会阴手术后究竟是结肠腹壁造瘘有优势,还是人工肛门重建有优势,仍存在争议。Objective:To compare the quality of life in patients with low rectal cancer who underwent abdominal perineal resection with definitive colostomy or perineal colostomy.Methods:Seventy-nine patients with ultra-low rectal cancer who underwent definitive colostomy or perineal colostomy after abdominal perineal resection from January 2015 to June 2019.They were surveyed by EORTC QLQ-C3O and QLQ-CR38 questionnaire.Fifty-one patients underwent definitive colostomy(DC group),and 28 patients underwent perineal colostomy(PC group).Results:According to QLQ-C30 analysis,the PC group was superior to the colostomy group in terms of social function(P<0.05);In terms of fatigue,the scores of patients in the PC group were 29.36,which was much lower than those in the DC group(39.65,P<0.05).In terms of diarrhea and Financial difficulties,the scores of the PC group were higher than those of the DC group(P<0.05,respectively),while there were no statistical differences in other functional and symptom areas.There was no statistical difference between the two groups in QLQ-CR38 related fields.Conclusions:The study compared the postoperative quality of life between the two surgical methods,and there was no statistically significant difference in the total quality of life between the two groups.It is still controversial whether the DC or the PC has an advantage after abdominal perineal resection for ultra-low rectal cancer.

关 键 词：低位直肠癌 结肠腹壁造瘘术 会阴造瘘术 生活质量 

分 类 号：R735.37[医药卫生—肿瘤]