肠液回输对低位直肠癌末端回肠造口术后肛门功能、胃肠功能及营养状态的影响  

Effects of intestinal fluid infusion on anal function,gastrointestinal function and nutritional status after terminal ileostomy for low rectal cancer

作　　者：张晶芬 邹婷 何雪姣 Zhang Jingfen;Zou Ting;He Xuejiao(Department of Surgical Oncology,Zhejiang Jinhua Guangfu Cancer Hospital,Jinhua 321000,China)

机构地区：[1]浙江金华广福肿瘤医院肿瘤外科,金华321000

出　　处：《中国医师进修杂志》2024年第8期709-712,共4页Chinese Journal of Postgraduates of Medicine

基　　金：金华市科技计划项目(2021-4-084)。

摘　　要：目的分析肠液回输辅助治疗对低位直肠癌患者末端回肠造口术后肛门功能、胃肠功能、营养状况的影响。方法回顾性选择浙江金华广福肿瘤医院2021年7月至2023年1月收治的80例低位直肠癌患者为研究对象,按治疗方法不同分为对照组(采用直肠癌根治术+末端回肠造口术,40例)和试验组(采用直肠癌根治术+末端回肠造口术+肠液回输辅助治疗,40例)。比较两组手术前后肛门功能、胃肠激素及营养状况指标水平。结果术后3个月试验组肛管最大收缩压、直肠顺应性、肛管最大静息压、直肠便意感觉容量高于对照组[(169.72±12.04)mmHg(1 mmHg=0.133 kPa)比(160.42±11.58)mmHg、(4.88±0.17)mmHg比(4.20±0.14)mmHg、(40.73±4.31)mmHg比(36.05±4.09)mmHg、(80.31±8.27)ml比(72.53±7.39)ml],差异有统计学意义(P<0.05)。试验组术后9 d胃泌素、胃动素、前白蛋白、白蛋白、血红蛋白水平高于对照组[(260.59±31.57)ng/L比(224.61±25.01)ng/L、(91.73±10.58)ng/L比(65.65±7.01)ng/L、(167.89±18.14)mg/L比(152.34±16.01)mg/L、(24.58±2.89)g/L比(21.49±2.47)g/L、(79.84±8.67)g/L比(70.59±8.01)g/L],差异均有统计学意义(P<0.05)。试验组营养不良发生率低于对照组[10.00%(4/40)比27.50%(11/40)],差异有统计学意义(χ^(2)=4.02,P<0.05)。结论低位直肠癌患者末端回肠造口术后采用肠液回输辅助治疗可改善肛门功能、胃肠功能及营养状况。Objective:To analyze the effects of assisted intestinal fluid infusion on anal function,gastrointestinal function and nutritional status of patients with low rectal cancer after terminal ileostomy.Methods:Eighty patients with low rectal cancer admitted to Zhejiang Jinhua Guangfu Cancer Hospital from July 2021 to January 2023 were selected as the study objects,and 40 patients performed radical operation and terminal ileostomy(control group),40 patients performed radical operation and terminal ileostomy and intestinal fluid infusion(experimental group).The anal function indexes,gastrointestinal hormone indexes,intestinal mucosal barrier function indexes and nutritional status indexes were compared before and after operation between the two groups.Results:After operation for 3 months,the maximum systolic pressure of anal canal,rectal compliance,maximum resting pressure of anal canal,rectal bowel inclination sensory volume in the experimental group were higher than those in the control group:(169.72±12.04)mmHg(1 mmHg=0.133 kPa)vs.(160.42±11.58)mmHg,(4.88±0.17)mmHg vs.(4.20±0.14)mmHg,(40.73±4.31)mmHg vs.(36.05±4.09)mmHg,(80.31±8.27)ml vs.(72.53±7.39)ml,there were statistical differences(P<0.05).After operation for 9 d,the levels of gastrin(GAS),motilin(MTL),prealbumin(PA),albumin(Alb)and hemoglobin(Hb)in the experimental group were higher than those in the control group:(260.59±31.57)ng/L vs.(224.61±25.01)ng/L,(91.73±10.58)ng/L vs.(65.65±7.01)ng/L,(167.89±18.14)mg/L vs.(152.34±16.01)mg/L,(24.58±2.89)g/L vs.(21.49±2.47)g/L,(79.84±8.67)g/L vs.(70.59±8.01)g/L,there were statistical differences(P<0.05).The incidence of malnutrition in the experimental group was lower than that in the control group:10.00%(4/40)vs.27.50%(11/40),there was statistical difference(χ^(2)=4.02,P<0.05).Conclusions:The use of intestinal fluid infusion as an adjuvant therapy after distal ileostomy in patients with low rectal cancer can improve anal function,gastrointestinal function,and nutritional status.

关 键 词：直肠肿瘤 末端回肠造口术 肠液回输 营养状况 

分 类 号：R735.37[医药卫生—肿瘤]