低位直肠癌患者保肛术后肛门功能锻炼方案的构建研究  

Construction of anal functional exercise management after the anus-preserving surgery in patients with low rectalcancer

作　　者：李冬 彭飞 朱小民 朱启媛 LI Dong;PENG Fei;ZHU Xiaomin;ZHU Qiyuan(Department of General Surgery,the Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China;Department of Nursing,the Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China)

机构地区：[1]海军军医大学第二附属医院普外科,上海200003 [2]海军军医大学第二附属医院护理处,上海200003

出　　处：《护士进修杂志》2024年第12期1322-1325,1330,共5页Journal of Nurses Training

基　　金：海军军医大学第二附属医院护理资助课题(编号:CZYY-HLM919);上海"医苑新星"青年医学人才培养项目(沪卫人事[2021]99号)。

摘　　要：目的 构建低位直肠癌患者保肛术后肛门功能锻炼护理方案并验证其临床应用效果。方法 通过文献查阅、小组讨论及直肠癌患者术后实际情况,制定符合直肠癌保肛术后渐进性肛门功能锻炼方案。选取我科2021年1月-2022年6月收治的低位直肠癌患者80例,按随机数字表法分为对照组和观察组,每组各40例;对照组采用常规术后肛门功能锻炼法,观察组在对照组基础上采用保肛术后肛门功能锻炼操进行训练。比较2组患者术后肛门功能锻炼执行率情况、肛门功能的恢复情况、并发症发生情况。结果 观察组患者术后肛门功能锻炼执行率优于对照组,差异有统计学意义(P<0.05)。观察组患者肛门功能评分低于对照组,差异有统计学意义(P<0.05)。观察组患者术后腹泻、肠梗阻的并发症发生少于对照组,差异有统计学意义(P<0.05)。结论 本研究构建的低位直肠癌患者保肛术后肛门功能锻炼康复方案在临床中应用效果较好,不但解决了患者术后肛门功能恢复差、并发症多等问题,还对患者术后肛门功能康复起到了很好的促进作用,提高患者生活质量。Objective To construct a nursing management of anal function exercise after the anus-preserving surgery for patients with low rectal cancer and to verify its clinical application effect.Method Through the literaturereview,group discussion,and clinical application of patients with rectal cancer after surgery,the progressive anal function exercise program was formulated in line with the anus-preserving surgery for rectal cancer.A total of 80 patients with low rectal cancer patients admitted to our department from January 2021 to June 2022 were selected,and divided into 2 groups according to the randomized numerical table method,with 40 cases in each group.The control group was treated with routine postoperative anal function exercise,while the observation group was trained with anal function exercise after anus-preserving surgery on the basis of the control group.The implementation rate of postoperative anal function exercise,the recovery of anal function,and the occurrence of complications between 2 groups were compared.Results The implementation rate of anal function exercise in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).The anal function score of the observation group one month after operationwas statistically lower than that of the control group,and the differencewas statistically significant ( P <0.05). The incidence of postoperative diarrhea and intestinal obstruction in theobservation group was less than thosein the control group, and the difference was statistically significant ( P <0.05).Conclusion In this study,the rehabilitation program of anal function exercise for patients with low rectal cancer afteranus-preserving surgery has a good application effect in clinical practice. It not only solves the problems of poorpostoperative anal function recovery and many complications, but also plays a good role in promoting therehabilitation of anal function and improving the quality of life of patients.

关 键 词：低位直肠癌 保肛术 肛门功能锻炼 临床应用 

分 类 号：R473.73[医药卫生—护理学] R735.3[医药卫生—临床医学]