宫颈癌治疗对患者排便功能影响的研究

Study on the effect of cervical cancer treatment on patients'defecation function

目的了解宫颈癌患者治疗后排便功能异常的发生情况及治疗方式对宫颈癌患者治疗后排便功能的影响。方法选取2018年12月至2019年4月就诊于首都医科大学附属北京妇产医院妇科肿瘤门诊、宫颈癌治疗后随访时间≥3个月的患者,进行关于排便功能的问卷调查。根据不同治疗方法分为3组:手术治疗组(A组,47例)、放(化)疗组(B组,144例)、手术加放(化)疗组(C组,40例)。比较3组患者排便功能异常情况。结果231例宫颈癌治疗后随访患者中有118例(51.08%)发生排便异常,其中17例发生便秘(7.36%);104例患者发生放射性直肠炎(56.52%)。A组便秘的发生率高于B组(17.02%vs 3.47%,P<0.05),A组与C组便秘发生率比较,差异无统计学意义(P>0.05);B组放射性直肠炎发生率显著高于C组(63.89%vs 30.00%,P<0.05)。结论宫颈癌患者治疗后排便功能异常较为常见,应引起临床医师重视。与单纯手术相比,术后辅助放(化)疗不增加便秘的发生率。与单纯放疗患者相比,手术后放(化)疗患者放射性直肠炎发生率更低。

Objective To investigate abnormal defecation function of the patients with cervical cancer after treatment,and to discuss the effect of different therapies on defecation functions after treatment.Methods Selected patients who were treated in the Gynecological Oncology Clinic of the Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University from December 2018 to April 2019,and were followed up for more than 3 months after cervical cancer treatment.Data were collected through questionnaire of defecation function.According to different treatments,they were divided into three groups:surgical treatment group(group A,47 cases),radiotherapy(or chemoradiotherapy)group(group B,144 cases),Surgical+radiotherapy(or chemoradiotherapy)group(group C,40 cases).Compared the abnormal defecation function among the three groups.Results Of the 231 patients with cervical cancer treated and followed up,118 cases(51.08%)had abnormal defecation function,of which 17 had constipation(7.36%);104 had radiation proctitis(56.52%).The incidence of constipation in group A was higher than that in group B(17.02%vs 3.47%,P<0.05).There was no significant difference in the incidence of constipation between group A and group C(P>0.05);the incidence of radiation proctitis in group B was significantly higher than that in group C(63.89%vs 30.00%,P<0.05).Conclusion Abnormal defecation is prevalence in women treated for cervical cancer.This fact should arouse the attention of clinicians.Postoperative adjuvant radiotherapy does not increase the incidence of constipation.The incidence of radiation proctitis was lower in patients treated with surgical and radiotherapy than in radiotherapy.