老年直肠癌低位直肠前切除术后肛门功能初探

Evaluation of anal function after low anterior resection of rectal cancer in elder patients

目的探讨低位直肠前切除术在老年患者直肠癌中的应用和临床疗效。方法随访1999年3月—2005年5月行低位直肠前切除术治疗直肠癌73例,按年龄分为70岁以上组(A)和70岁以下组(B),分别对两组患者6个月、12个月时的肛门功能按徐忠法肛门功能评价方法进行评分。结果6个月时肛门功能A组优(0/38)、良(17/38)、一般(10/38)、差(11/38),B组优(0/35)、良(6/35)、一般(19/35)、差(10/35);12个月时肛门功能A组优(9/38)、良(16/38)、一般(6/38)、差(7/38),B组优(5/35)、良(16/35)、一般(9/35)、差(5/35),运用卡方拟合优度检验,6个月时,A、B两组肛门功能恢复程度有差异;12个月时,A、B两组肛门功能恢复程度无差异。结论随着时间的推移,老年患者低位直肠吻合术后肛门功能同一般低位直肠吻合术后患者肛门功能无差异。

Objective To evaluate the application and clinical curative effects of anal-preserving low anterior resection on rectal cancer in elder patients. Methods Seventy-three cases of low anterior resection of rectal cancer （ from March 1999 to May 2005 ） were divided according to the ages into group A （ 〉 70 years, 38 cases） and （ 〈70 years, 35 cases）. The anal functions in two groups were evaluated after 6 months and 12 months and were graded according to XU Zhong-fa Anal-function Evaluation Method. Results Anal function was 0 case of excellent, 17 cases of good, 10 cases of moderate and 11 cases of poor respectively in group A after 6 months while there was 0 case of excellent, 6 cases of good, 19 cases of moderate and 10 cases of poor in group B. After 12 months there were 9, 16,6 and 7 cases being excellent, good, moderate and poor respectively in group A while there were 5,16,9 and 5 cases being excellent, good, moderate and poor respectively in group B. g2 calculation by goodness-of-fit test showed that there were significant differences between group A and group B in recovery degree of anal function at 6 months post surgery. Recovery of anal function had no significant differences between patients in group A and group B at 12 months. Conclusion Anal function of post anterior resection of low rectal cancer in elderly patients has no significant difference with those of relatively younger adult patients with the lapse of time.