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目的评价高龄患者低位直肠癌保肛手术后的肛门控便功能。方法对年龄在75岁以上、肿瘤距肛缘7cm以下、采用保肛手术治疗的39例低位直肠癌患者,按吻合口位置和手术方式分组,研究术后控便情况。结果患者排便次数达到正常的时间为术后(9.8±2.9)个月。肛门控便情况和直肠测压结果在低位吻合组与超低位吻合组及肛管吻合组之间比较,差异均无统计学意义(P>0.05);肛管吻合组与超低位吻合组之间比较,差异有统计学意义(P<0.05)。贮袋组术后(7.7±1.7)个月排便次数趋于正常,与直吻组(10.6±2.8)个月比较,差异有统计学意义(P<0.01);术后36.1%的患者出现I度失禁的表现,贮袋组与直吻组比较,差异无统计学意义(P>0.05);保肛术后贮袋组直肠测压指标优于直吻组。结论高龄患者采用结肠贮袋直肠肛管吻合术能够明显改善近期的控便功能。
Objective To evaluate the anal control and defecation function of the anorectal surgery in elderly patients with low rectal cancer. Methods Thirty-nine patients with low rectal cancer who underwent anal sphincter preservation surgery under the age of 75 years and older with the tumor below the anal margin of 7 cm were grouped according to the position of the anastomosis and the operation method to study the postoperative control. Results The frequency of defecation in patients reached normal after (9.8 ± 2.9) months. Anal control and rectal manometry results in the low anastomosis group and the ultra-low anastomosis group and anal anastomosis group, the difference was not statistically significant (P> 0.05); anal anastomosis group and ultra-low anastomosis between groups The difference was statistically significant (P <0.05). The number of defecation tended to be normal in the storage bag group (7.7 ± 1.7) months after operation, which was significantly different from that in the direct kiss group (10.6 ± 2.8) months (P <0.01), and 36.1% The degree of incontinence, storage bag group and straight kiss group, the difference was not statistically significant (P> 0.05); after anal sphincter preservation bag group rectal pressure was better than direct kiss group. Conclusion The elderly patients with colostomy bag anorectal anastomosis can significantly improve the recent control of stool function.