新疆地区单中心88例慢性放射性直肠损伤患者的临床资料分析  

Clinical analysis of 88 patients with chronic radiation-induced rectal injury in a single center from Xinjiang Uygur Autonomous Region

作　　者：伊敏江·托合提 高维鸽[1] 李涛[1] 马腾辉[2] Yiminjiang Tuoheti;Gao Weige;Li Tao;Ma Tenghui(Gastrointestinal Surgery Medical Diagnosis and Treatment Center,People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Department of General Surgery(Division of Colorectal Surgery,Radiation Intestinal Injury Center),The Sixth Affiliated Hospital of Sun Yat-sen University/Guangdong Key Laboratory for Colorectal and Pelvic Floor Diseases/Huangpu District Bio-medical Innovation Research Institute,Guangzhou 510655,Guangdong,China)

机构地区：[1]新疆维吾尔自治区人民医院胃肠外科医学诊疗中心,新疆乌鲁木齐830001 [2]中山大学附属第六医院普通外科(结直肠外科、放射性肠损伤中心)/广东省结直肠盆底疾病研究重点实验室/广州市黄埔区中六生物医学创新研究院,广东广州510655

出　　处：《结直肠肛门外科》2025年第1期22-26,共5页Journal of Colorectal & Anal Surgery

摘　　要：目的总结新疆地区慢性放射性直肠损伤患者的临床诊疗经验。方法回顾性分析新疆维吾尔自治区人民医院2019年1月至2024年10月收治的88例慢性放射性直肠损伤患者的临床资料,将患者分为毛细血管扩张型组(n=56)、溃疡型组(n=17)、狭窄型组(n=6)及混合型组(n=9),对患者疗效及随访结果进行分析。结果不同分型患者间的年龄、BMI、血清白蛋白水平、治疗方式比较差异有统计学意义(P<0.05),性别、病程、是否合并基础疾病、血红蛋白水平及肿瘤标志物阴性/阳性情况比较差异无统计学意义(P>0.05)。患者经过治疗后总有效率为90.9%,各临床分型之间治疗效果比较差异无统计学意义(Z=3.109,P=0.375)。88例患者中有23例采用手术治疗,其中13例采用肠造口术,10例采用责任病灶切除术,存在腹部切口。采用肠造口术的患者与采用责任病灶切除术的患者的术前VAS评分比较差异无统计学意义(P>0.05),术后2周患者的VAS评分均降低,且采用责任病灶切除术患者的VAS评分低于采用肠造口术患者的VAS评分,比较差异有统计学意义(P<0.05)。采用责任病灶切除术患者的术后腹部切口疼痛缓解情况较采用肠造口术患者的好,差异有统计学意义(Z=-2.790,P=0.005)。结论新疆地区慢性放射性直肠损伤患者多为毛细血管扩张型,经过治疗后总有效率较高,责任病灶切除术术后腹部切口疼痛缓解情况优于肠造口术。Objectives To summarize the diagnostic and therapeutic experiences of patients with chronic radiationinduced rectal injury in Xinjiang Uygur autonomous region.Methods A retrospective analysis was conducted on the clinical data of 88 patients with radiation-induced rectal injury admitted to the People’s Hospital of Xinjiang Uygur Autonomous Region between January 2019 and October 2024.Patients were classified into four subtypes:telangiectasia(n=56),ulcerative(n=17),stenotic(n=6),and mixed(n=9).Therapeutic outcomes and follow-up data were analyzed.Results Significant differences were observed among the groups in age,body mass index,serum albumin levels,and treatments(P<0.05),while no differences were found in gender,disease duration,comorbidities,hemoglobin levels,or tumor marker positivity(P>0.05).The overall response rate after treatment was 90.9%,with no significant difference in efficacy among subtypes(Z=3.109,P=0.375).Among the 88 patients,23 underwent surgical treatment,including 13 who underwent enterostomy and 10 who received target lesion resection,with abdominal incisions present.Preoperative VAS scores showed no statistical difference between patients undergoing enterostomy and those undergoing target lesion resection(P>0.05).At 2 weeks postoperatively,VAS scores decreased significantly,with lower scores in the target lesion resection group compared to the enterostomy group(P<0.05).Compared with patients who underwent enterostomy,postoperative abdominal incision pain relief was significantly better in the target lesion resection group(Z=-2.790,P=0.005).Conclusion Chronic radiation-induced rectal injury in Xinjiang Urumqi Autonomous presents as the telangiectasia subtype,with a high overall treatment efficacy.Target lesion resection provided superior postoperative pain relief compared to enterostomy.

关 键 词：放射性直肠损伤 临床疗效 手术 治疗 

分 类 号：R730.55[医药卫生—肿瘤]