直肠癌保肛术前肛门功能评估的初步调查研究

目的探讨肛门直肠测压在中低位直肠癌保肛术前评估肛门功能的临床应用。方法采用肛肠动力检测系统（ARM）记录107例中低位直肠癌患者手术前的直肠肛管压力指标,采用向量测压软件分析系统临床数据。结果中低位直肠癌患者的肛管静息压比健康者轻度升高,直肠最小感觉阈值、初始排便阈值比健康者明显升高;不同性别患者的肛管长度、肛管最大收缩压差异有统计学意义（P〈0.05）,中位及低位直肠癌患者的肛管最大收缩压差异有统计学意义（P〈0.05）,〈60岁组和≥60岁组的直肠癌患者的肛管静息压、肛管最大收缩压差异有统计学意义（P〈0.05）。结论性别、年龄、肿瘤位置都是直肠癌患者肛门功能的影响因素。肛门直肠测压可以了解中低位直肠癌患者肛门内外括约肌的情况和评估患者的持便控便能力。

Preliminary study of evaluating anal function of middle or low rectal cancer patients before anus reservation operation

Objective To investigate the clinical application of anorectal manometry in evaluating the anal function for middle or low rectal cancer patients before anus reservation operation. Methods The detection system of anorectal dynamics（Laborie anorectal manometry, ARM） was used to record anorectal pressure of 107 patients with middle or low rectal cancer before operation and the clinical data was analyzed by vector pressure software. Results The anal canal resting pressure of patients with middle or low rectal cancer was slightly higher, while the minimum perception threshold and initial defecating sensation volume were obviously higher than the healthy controls. There was a significant difference in anal length and anal maximal contraction pressure between male and female patients with middle or low rectal cancer（P〈0.05）. For anal maximal contraction pressure, there were differences between patients with middle and low rectal cancer（P〈0.05）. Between younger than and older than sixty years old patients, anal resting pressure and anal maximal contraction pressure had significant differences. Conclusion Gender, age and tumor location are the impact factors to anal function of rectal cancer. Anorectal manometry can be used to detect the function of internal and external anal sphincter and to evaluate self-control ability in defecation for middle or low rectal cancer patients.