结肠肛管吻合术与低位直肠癌前切除术治疗低位直肠癌的临床疗效对比  

Comparison of clinical efficacy of coloanal anastomosis and preresectionof low rectal cancer in the treatment of low rectal cancer

作　　者：孔伟博 李会力 张定喜 KONG Weibo;LI Huili;ZHANG Dingxi(Department of General Surgery,Xuchang People's Hospital,Xuchang 461000,China)

机构地区：[1]许昌市人民医院普外科,河南许昌461000

出　　处：《黑龙江医药科学》2025年第4期57-59,62,共4页Heilongjiang Medicine and Pharmacy

基　　金：河南省医学科技攻关联合共建项目,编号:LHGJ20192181。

摘　　要：目的:探究结肠肛管吻合术(Parks术)与低位直肠癌前切除术(Dixon术)在低位直肠癌中的应用价值。方法:选取2021年2月至2023年5月许昌市人民医院收治的86例低位直肠癌患者,采用随机数字表法分为两组,各43例。Dixon组采用Dixon术,Parks组采用Parks术。比较两组手术相关指标、手术前后血清炎症指标[C反应蛋白(C-reactive protein, CRP)、白细胞介素-6(interleukin-6,IL-6)、降钙素原(procalcitonin, PCT)]水平、胃肠功能指标[胃泌素(gastrin, GAS)、胃动素(motilin, MOT)、直肠最大耐受量(rectal maximum tolerance, MTV)]、排便功能及术后并发症发生率。结果:Parks组手术时间长于Dixon组,术中出血量高于Dixon组,首次排气时间、进半流质食物时间、住院时间短于Dixon组(P<0.05);术后1 d、3 d, Parks组血清CRP、IL-6、PCT水平低于Dixon组,MTV、GAS、MOT水平高于Dixon组(P<0.05);Parks组排便功能优良率95.35%高于Dixon组79.07%(P<0.05);两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论:Parks术与Dixon术均为低位直肠癌患者安全有效的治疗方案,Parks术虽会延长手术时间,但能减轻炎症,促进术后早期胃肠功能恢复。Objective:To explore the application value of colon-anal anastomosis(Parks procedure)and low rectal cancer anterior resection(Dixon procedure)in low rectal cancer.Methods:A total of 86 patients with low rectal cancer were selected from Xuchang People's Hospital from February 2021 to May 2023 and divided into two groups by random number table method,with 43 cases in each group.The Dixon group received Dixon surgery,and the Parks group received Parks surgery.The surgery-related indicators,preoperative and postoperative serum inflammatory indicators[C-reactive protein(CRP),interleukin-6(IL-6),procalcitonin(PCT)]levels,gastrointestinal function indicators[gastrin(GAS),motilin(MOT),rectal maximum tolerance(MTV)],defecation function,and postoperative complication rate were compared between the two groups.Results:The Parks group had a longer operation time and higher intraoperative blood loss than the Dixon group,while the time to the first bowel movement,the time to semi-liquid food intake,and the length of hospital stay were shorter than those in the Dixon group(P<0.05).On postoperative days 1 and 3,the levels of serum CRP,IL-6,and PCT were lower in the Parks group than in the Dixon group,while the levels of MTV,GAS,and MOT were higher in the Parks group than in the Dixon group(P<0.05).The excellent and good rate of defecation function in the Parks group 95.35%was higher than that in the Dixon group 79.07%(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Both Parks and Dixon procedures are safe and effective treatment options for patients with low rectal cancer.Although Parks procedure can prolong the duration of surgery,it can alleviate inflammation and promote early postoperative gastrointestinal function recovery.

关 键 词：直肠癌 结肠肛管吻合术 直肠低位前切除术 炎症因子 胃肠动力 排便功能 并发症 

分 类 号：R735.37[医药卫生—肿瘤]