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| 中西医结合疗法改善低位直肠癌完全经肛门括约肌间切除术后患者肛门功能的临床研究 |
| 张旭,赵磊,林峰,薛帆,刘文志,崔佑刚,衣宇鹏,孔祥余,冯宁 |
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| 大连大学附属中山医院胃肠外科辽宁大连 116001 |
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| 摘要: |
| 目的:探讨中西医结合疗法在加速低位直肠癌完全经肛门括约肌间切除术(ISR)切除术后肛门功能恢复中的作用。方法:回顾性分析2016年1月—2019年1月大连大学附属中山医院胃肠外科收治的43例低位直肠癌接受完全ISR切除手术患者的临床资料，对照组21例，治疗组22例。所有患者严格遵守直肠全系膜切除术(TME)原则行完全ISR手术。对照组术后予生活方式干预(戒烟、运动)、饮食因素调整、提肛运动，口服洛哌丁胺治疗；治疗组在对照组的基础上，增加针刺治疗、口服中药汤剂及中药坐浴治疗。采用Williams标准及Wexner评分系统评估术后肛门功能恢复情况。动态跟踪观察随访两组患者肛门功能至术后12个月。结果:Williams肛门功能评估:治疗组患者术后3个月的肛门功能良好率均优于对照组，差异有统计学意义(P=0.044)，术后1、6、12个月时差异无统计学意义(P>0.05)。肛门失禁Wexner评分:治疗组患者术后1、3、6个月肛门失禁Wexner 评分明显低于对照组，差异有统计学意义(P<0.05)，术后12个月，两组差异无统计学意义(P>0.05)。结论:中西医结合疗法能够加速低位直肠癌完全ISR切除患者术后肛门功能的恢复，降低术后肛门失禁发生率，在前期(术后3~6个月)时效果显著。 |
| 关键词: 中西医结合 低位直肠肿瘤 内括约肌切除术 肛门功能 |
| DOI：10.3969/j.issn.1007-6948.2020.02.020 |
| 投稿时间：2019-12-28 |
| 基金项目:2017年大连市医学科学研究计划项目资助(1711112) |
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| Clinical Study in the Effect of the Combined Therapy of Traditional Chinese Medicine and Western Medicine on the Improvement of Anal Function in Patients with Low Rectal Cancer after ISR |
| ZHANG Xu,ZHAO Lei,LIN Feng |
| Department of Gastrointestinal Surgery, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China |
| Abstract: |
| Objective To investigate the effect of combined therapy of traditional Chinese medicine and western medicine in improving anal function recovery after ISR resection for low rectal cancer. Methods We retrospectively analyzed the clinical data of 43 patients with low rectal cancer treated by gastrointestinal surgery department of affiliated Zhongshan hospital of Dalian university from January 2016 to January 2019. They all accepted complete ISR resection following TME principles, including 21 patients in the control group and 22 patients in the treatment group. The control group received lifestyle intervention (smoking cessation, exercise), dietary adjustment, anal levator exercise, oral loperamide treatment, while the treatment group received acupuncture treatment, oral traditional Chinese medicine treatment and traditional Chinese medicine bath on the basis of the control group. The postoperative recovery of anal function was evaluated by Williams standard and Wexner scoring system. The two groups of patients were followed up continuously for 12 months after the operation. Results In the Williams evaluation system, the anus functions at 1, 3, 6 and 12 months after operation were better in the treatment group than those in the control group, with the positive statistical significance at 3 months after operation (P=0.044). No statistical significance could be found at 1, 6 and 12 months after operation (P>0.05). Wexner scoring system showed that the anal incontinence in the treatment group was better than that of the control group at 1, 3 and 6 months after surgery (P<0.05). Conclusion The combined therapy of traditional Chinese medicine and western medicine can accelerate the recovery of postoperative anal function and reduce the incidence of postoperative anal incontinence. |
| Key words: The combined therapy of traditional Chinese medicine and western medicine low rectal tumor internal sphincterectomy anal function. |
