排便功能训练对保肛术后患者排便功能的影响

目的 探讨低位直肠癌保肛手术患者进行排便功能训练对肛门排便功能的影响。方法 将110例行低位前切除术的直肠癌患者按吻合口距齿状线的距离分为两组(A组:1.0~2.0cm,B组:2.0~3.0cm),术后对其进行排便功能训练,分别在术后3个月及1年进行Wexner评分,术后1年进行大便失禁生活质量问卷(FIQL)调查。结果 术后2～6周,患者排便次数控制在6～8次/d。8～14周,大便成形,次数控制在3～4次/d,并随着时间推移逐渐减少。术后3个月,A组的Wexner评分高于B组(P＜0.05);1年后,两组的Wexner评分无统计学意义(P＞0.05)。术后1年的FQIL问卷调查中,A、B两组各项指标均接近正常。结论 排便功能训练使患者的排便自控能力及生活质量得到不同程度的改善。

Effectiveness of defecation functional training for patients after sphincter preservation

Objective To study the effectiveness of defecation functional training for patients after sphincter preservation. Methods 110 patients after low anterior resection for rectal cancer were divided into 2 groups according to the distance between anastomosis and dentate line （group A： 1.0- 2.0 cm, group B： 2.0-3.0 cm）. All of them received defecation training, and were tested by Wexner scoring systems 3 months and 1 year after surgery, FIQL questionnaires were given 1 year after surgery. 36 healthy people without anus-rectal disease and disordered defecation function were selected as control group. Results 2 to 6 weeks after surgery, the patients defecated 6 to 8 times a day. 8 to 14 weeks after surgery, however, the patients produced well-formed bowel, and defecated 3 to 4 times a day. The Wexner scores in group A were higher than that in group B 3 months after surgery（P 〈 0. 05）, but there are no significant differences between 2 groups after 1 year of functional training （P〉0.05）. All targets of FIQL questionnaires in group A and B were close to normal. Conclusion Funcional training can improve patients＇ self-control ability of defecation and quality of life.