高龄患者直肠癌保肛术后控便管理方法的探讨

Bowel control of lower anus-preserving operation in aged patients

目的评价高龄患者低位直肠癌保肛手术后的大便管理能力。方法对年龄在75岁以上、肿瘤距肛缘5 cm以下、采用保肛手术治疗的33例低位直肠癌患者随机分为观察组和对照组。对照组患者按直肠癌术后护理常规,观察组在此基础上进行术前缩肛功能指导及早期排便功能训练和控制大便训练,并对术后肛周皮肤护理方法做出新的探讨。结果术后1月两组排便功能差异有统计学意义,观察组优于对照组。结论术前缩肛功能指导及早期排便功能训练和控便训练有利于提高患者控便能力,术后初期预防性使用皮肤护理产品有利于保护皮肤,值得临床推广。

Objective To evaluate aged patients′ bowel management after low rectal cancer surgery.Methods We chose 33 patients who aged over 75 years,the tumor below 5 cm from the anal margin and the surgery style was rectal preserve surgery.We divided the 33 patients in two groups randomly.Matched group： we used the nursing routine to the postoperation rectal cancer patients.Control group： beyond the nursing routine,we told patients to reduce anal function preoperative,do early defecation training and control stool training.We also made a new study to perianal skin care methods.Results The control group patient′ bowel function was better than the matched group patients′ after 1 month（P〈0.1）.Conclusion Guide in reducing preoperative anal function,doing early defecation training and control stool training can help patients to improvethe ability of stool control.The early postoperative prophylactic use of skin protective film and transparent dressing can help to prefect the skin.