直肠黏膜环切术后肛门坠胀感的危险因素分析及防治策略

Risk Factors and Prevention Strategies of Anal Distension after Rectal Mucosal Resection

目的探究直肠黏膜环切术后肛门坠胀感的危险因素并制定相关防治策略。方法选取2018年4月—2019年4月在四川省成都市郫都区人民医院行直肠黏膜环切术的患者70例,观察术后肛门坠胀感的发生情况并进行统计分析,按照有无肛门坠胀感分为有肛门坠胀感组和无肛门坠胀感组,采用单因素及多因素Logistic回归分析筛选其独立危险因素。结果共有22例患者主诉有肛门坠胀感,术后常规使用抗生素等药物12例,两组在病程,术后用药,吻合口位置高低方面差异无统计学意义(P>0.05),两组性别,年龄和术后满意度差异有统计学意义(P<0.05),在筛选独立危险因素后发现,性别(OR=3.47,95%CI:1.16,10.40)、年龄(OR=2.59,95%CI:1.90,7.46),合并用药(OR=2.63,95%CI:1.87,7.95),手术满意与否(OR=4.04,95%CI:1.36,12.02),吻合口位置(OR=0.24,95%CI:0.07,0.91)是直肠黏膜环切术后肛门坠胀感的独立危险因素,差异有统计学意义。结论直肠黏膜环切术后肛门坠胀感的发生与性别、手术满意与否以及吻合口位置有关,应注意术中吻合口的位置,术后满意与否是患者产生坠胀感的可能因素。

Objective To explore the risk factors of anal bulging after rectal mucosal resection and formulate related prevention and treatment strategies.Methods A total of 70 patients who underwent rectal mucosal resection in People's Hospital of Pidu District from April 2018 to April 2019 were selected to observe the postoperative anal bloating sensation and perform statistical analysis.In the group with anal swell and the group without anal swell,the independent risk factors were screened using single factor and multifactor logistic regression analysis.Results A total of 22 patients complained of anal bloating,and 12 patients were routinely treated with antibiotics and other drugs.There was no statistical difference between the two groups in the course of disease,postoperative medication,and anastomotic position(P>0.05).Whether there is a difference in age and postoperative satisfaction is statistically significant(P<0.05).After screening independent risk factors,it was found that gender(OR=3.47,95%CI:1.16,10.40),age(OR=2.59,95%CI:1.90,7.46),combined medication(OR=2.63,95%CI:1.87,7.95),surgical satisfaction(OR=4.04,95%CI:1.36,12.02),anastomotic location(OR=0.24,95%CI:0.07,0.91)is an independent risk factor for anal bloating after rectal mucosal circumcision,which is statistically significant.Conclusion The occurrence of anal bulging after rectal mucosal circumcision is related to gender,whether the operation is satisfactory and the position of the anastomosis.Attention should be paid to the position of the anastomosis during operation.Satisfaction after operation is a possible factor for the patient to feel bulging.