直肠癌保肛术后患者低位前切除综合征发生现状及其影响因素分析  

Current status and influencing factors of low anterior resection syndrome in rectal cancer patients with sphincter-preserving surgery

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作  者:马雪倩 许佳琪 杨亚楠 于淼[1] 陈泓伯 李葆华[1] Ma Xueqian;Xu Jiaqi;Yang Yanan;Yu Miao;Chen Hongbo;Li Baohua(Nursing Department,Peking University Third Hospital,Beijing 100191,China;School of Nursing,Peking University,Beijing 100191,China)

机构地区:[1]北京大学第三医院护理部,北京100191 [2]北京大学护理学院,北京100191

出  处:《中华现代护理杂志》2024年第34期4646-4653,共8页Chinese Journal of Modern Nursing

摘  要:目的调查直肠癌保肛术后患者低位前切除综合征(LARS)的发生情况并分析相关因素。方法本研究为横断面调查。采用便利抽样法,选取2021—2023年于北京大学第三医院住院的直肠癌保肛术后患者195例为研究对象。采用一般资料调查表、LARS量表、视觉模拟评分法、中文版失眠严重程度指数对患者进行调查。结果本研究共发放问卷195份,回收有效问卷156份,问卷有效回收率为80.00%(156/195)。156例直肠癌保肛术后患者中LARS发生率为36.54%(57/156),重度LARS发生率为15.38%(24/156)。二项Logistic回归分析显示,性别(OR=0.445,P=0.034)、术前新辅助放化疗(OR=6.343,P<0.01)是直肠癌保肛术后患者LARS发生的影响因素;术前新辅助放化疗(OR=3.322,P=0.047)、术中预防性造口(OR=4.855,P=0.035)是重度LARS发生的影响因素。直肠癌保肛术后患者的LARS评分与焦虑得分(r=0.238,P=0.003)、失眠总分(r=0.168,P=0.036)均呈正相关。结论术前新辅助放化疗是直肠癌保肛根治术后LARS和重度LARS发生的独立危险因素,LARS与患者的焦虑情绪和失眠问题具有一定的相关性。ObjectiveTo explore the incidence of low anterior resection syndrome(LARS)in patients undergoing sphincter-preserving surgery for rectal cancer and analyze related factors.MethodsThis study was a cross-sectional survey.From 2021 to 2023,convenience sampling was used to select 195 patients with rectal cancer who underwent sphincter-preserving surgery at Peking University Third Hospital as participants.The patients were surveyed using the General Information Questionnaire,LARS Scale,Visual Analog Score,and Chinese version of Insomnia Severity Index.ResultsA total of 195 questionnaires were distributed,and 156 valid questionnaires were collected,with a valid response rate of 80.00%(156/195).The incidence of LARS in 156 rectal cancer patients with sphincter-preserving surgery was 36.54%(57/156),and the incidence of severe LARS was 15.38%(24/156).Binomial Logistic regression analyses showed that gender(OR=0.445,P=0.034)and preoperative neoadjuvant chemoradiotherapy(OR=6.343,P<0.01)were influencing factors for the occurrence of LARS in patients with rectal cancer after sphincter-preserving surgery.Preoperative neoadjuvant chemoradiotherapy(OR=3.322,P=0.047)and intraoperative prophylactic stoma(OR=4.855,P=0.035)were influencing factors for severe LARS.LARS score was positively correlated with anxiety score(r=0.238,P=0.003)and total insomnia score(r=0.168,P=0.036)in patients with rectal cancer who underwent sphincter-preserving surgery.ConclusionsPreoperative neoadjuvant chemoradiotherapy is an independent risk factor for postoperative LARS and severe LARS in rectal cancer patients undergoing sphincter-preserving surgery.LARS is correlated with patients'anxiety and insomnia.

关 键 词:直肠癌 保肛术 低位前切除综合征 情绪 睡眠 

分 类 号:R473.73[医药卫生—护理学]

 

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