保肛手术以及Miles手术在低位直肠癌治疗中的运用效果分析  

Analysis of the Effectiveness of Anal Sphincter Preservation Surgery and Miles Surgery in the Treatment of Low Rectal Cancer

作　　者：彭加祺 彭海[1] 洪智攀[1] 王学智[1] PENG Jiaqi;PENG Hai;HONG Zhipan;WANG Xuezhi(Department of Cancer Surgery,Chifeng Hospital,Chifeng 024000,Inner Mongolia Autonomous Region,China)

机构地区：[1]赤峰市医院肿瘤外科,内蒙古赤峰024000

出　　处：《系统医学》2025年第6期123-126,共4页Systems Medicine

摘　　要：目的评价保肛手术以及Miles手术在低位直肠癌治疗中的运用效果。方法非随机选取2019年10月—2022年10月到赤峰市医院治疗的90例低位直肠癌患者为研究对象,依据不同治疗方式分为保肛组(n=45,保肛手术)和M手术组(n=45,Miles手术),分析两组不良反应发生率、2年远处转移率、临床指标与生活质量。结果保肛组患者不良反应发生率为2.22%(1/45),低于M手术组的17.78%(8/45),差异有统计学意义(χ^(2)=6.049,P<0.05);保肛组2年远处转移率低于M手术组,保肛组平均手术时长、术后首次排气时长、术中出血量、术后住院时长少于M手术组,差异有统计学意义(P均<0.05);保肛组生活质量高于M手术组,差异有统计学意义(P均<0.05)。结论采用保肛手术方法对低位直肠癌患者的治疗成效优于Miles手术方法,能够缩短手术时长及术后排气和住院时长,减少术中出血量,降低不良反应发生率和2年远处转移率,提高其生活质量水平。Objective To evaluate the effect of anal preservation surgery and Miles surgery in the treatment of low rec-tal cancer.Methods Ninety cases of patients with low rectal cancer in Chifeng Hospital from October 2019 to October 2022 were non-randomly selected as study objects,and divided into anal preserving group(n=45,anal-preserving sur-gery)and M operation group(n=45,surgery by Miles)according to different treatment methods.Analyse the incidence of adverse reactions,2-year distant metastasis rate,clinical index and quality of life of the two groups.Results The probability of adverse reaction in the anal preserving group was 2.22%(1/45),lower than 17.78%(8/45)in the M op-eration group,and the difference was statistically significant(χ^(2)=3.873,P<0.05).The distant metastasis rate at 2 years was low than that in the M operation group,the mean operation duration,postoperative exhaust,postoperative bleed-ing,postoperative hospitalization were less than those in the M operation group,the differences were statistically sig-nificant(all P<0.05).The quality of life in the anal preserving group were higher than those of the M operation group,the differences were statistically significant(all P<0.05).Conclusion The treatment effect of anal preservation surgery for lower rectal cancer patients is better than Miles surgery,this approach can effectively shorten surgical duration,re-duce intraoperative blood loss,accelerate postoperative flatus passage and hospital discharge,while demonstrating lower incidence of adverse reactions and 2-year distant metastasis rate,ultimately improving patients'quality of life.

关 键 词：保肛手术 MILES手术 低位直肠癌 不良反应 手术指标 术中指标 

分 类 号：R735[医药卫生—肿瘤]