【摘要】 目的探讨结直肠钉式吻合术后排便功能的变化。方法对95例应用钉式吻合器行保肛手术的结直肠癌患者按吻合口距齿状线距离分为三组(超低位:<2cm;低位:2cm至腹膜反折处;高位:腹膜反折以上),以徐忠法五项十分制评价标准、自我评价等分别在术后2周、1个月、3个月、6个月、1年对排便功能进行评价。结果在2周、1个月、3个月、6个月、1年时,患者自我评价比徐氏评价分别低1.04±1.05、1.12±1.12、1.00±1.25、0.88±1.21和0.85±1.04(P<0.05);评价优者比例分别为0、2.1%、25.3%、38.9%、53.7%;随吻合口增高及时间推移,评分增加。腹泻与便秘交替:高位组不明显,3个月内超低位组无改善,低位组改善不明显(P=1.00,0.29);随时间推移,低位组改善不明显(P=0.04,0.01,0.00)。结论结直肠钉式吻合术后,患者对排便功能不满意。腹泻与便秘交替现象主要存在于超低及低位组,其中超低位组改善不佳。随着吻合口增高及时间推移,排便功能逐渐好转。更多还原

【Abstract】 Objective To investigate the change of defecation function after colorectal anastomosis with stapling technique.Methods 95 patients who received colorectal anastomosis with stapling technique were divided into 3 groups according to the distance between anastomosis and dentate line (ultra-low:<2 cm,low:2 cm to peritoneum invagination;high:above peritoneum invagination),who received evaluation with Zhong-Fa Xu′s evaluation criteria and self-evaluation at 2 weeks,1 month,3 months,6 months and 1 year after operation.Result At 2 weeks,1 month,3 months,6 months and 1 year,the self-evaluation was lower than Zhong-Fa Xu′s evaluation criteria with 1.04±1.05,1.12±1.12,1.00±1.25,0.88±1.21 and 0.85±1.04 (P<0.05) and the good level of evaluation took about 0,2.1%,25.3%,38.9%,53.7%.With the increased time and anastomotic plane,the ratings increased.About the alternating diarrhea and constipation:the high group was not obvious;there was no improvement in ultra-low group and little improvement in low group (P=1.00,0.29) within 3 months;over time,the low group improved more significantly(P=0.04,0.01,0.00).Conclusions Patients are not satisfied with defecation function after colorectal anastomosis with stapling technique.The phenomenon of alternating diarrhea and constipation principally exists in the ultra-low and low groups,and the ultra-low groups improve not significantly.With increased time and anastomotic plane,defecation function gradually improved.更多还原