直肠癌超低位吻合保肛术患者围手术期肛肠压力观察及护理

Observation and Nursing of Perioperative Anorectal Pressure in Patients with Rectal Cancer with Ultra-low Anastomosis

目的研究直肠癌超低位吻合保肛术患者围手术期肛肠压力变化以及相关的护理措施。方法研究对象抽取自我院在2017年1月至2020年1月纳入的100例确诊为直肠癌疾病,需要采用直肠癌超低位吻合保肛术进行治疗的患者,在其围手术期给予相应的护理干预措施,同时对其肛肠压力的变化情况进行密切观察,比较100例患者手术之前和手术之后的肛肠压力变化情况、术后并发症发生情况、术后半年复发率情况以及手术治疗前后Kirwan肛门功能评级情况。结果患者手术治疗4周后的直肠肛门抑制反射次数为(2.08±0.47)次,而手术治疗前为(23.97±1.28)次,差异有统计学意义(P<0.05);患者手术治疗4周后的肛管静息压为(19.98±8.26)mm Hg,而手术治疗前为(54.71±9.77)mm Hg,差异有统计学意义(P<0.05);患者手术治疗4周后的直肠顺应性为(5.25±1.16)mL/mm Hg,而手术治疗前为(14.01±1.94)mL/mm Hg,差异有统计学意义(P<0.05);患者手术治疗4周后的肛门最大收缩压为(63.37±28.84)mm Hg,而手术治疗前为(120.03±25.57)mm Hg,差异有统计学意义(P<0.05);患者治疗后的术后并发症发生率以及术后半年复发率分别为10.00%和6.00%。手术治疗4周后,所有患者的Kirwan肛门功能评级1级以及2级的患者例数均比手术治疗前更高,数据对比之后存在统计学意义(P<0.05)。结论在直肠癌患者治疗中,给予肠癌超低位吻合保肛术治疗的同时配合针对性的护理措施,对患者的肛肠压力以及肛门功能情况可起到良好的改善作用,有利于改善患者预后。

Objective To study the perioperative changes of anorectal pressure and related nursing measures in patients with rectal cancer undergoing ultra-low anastomosis to preserve anus.Methods The study subjects selected 100 patients who were diagnosed with rectal cancer disease and who needed to be treated with rectal cancer ultra-low anastomosis preserving surgery,who were enrolled in their hospital from January,2017 to January,2020.The corresponding nursing intervention measures were given during the period,and the changes in the anorectal pressure were closely observed.The changes in the anorectal pressure before and after the operation,the occurrence of postoperative complications,the recurrence rate of the six months after the operation,and the operation were compared in 100 patients.Kirwan's anal function rating before and after treatment.Results After 4 weeks of surgical treatment,the number of rectal and anal suppression reflexes was(2.08±0.47)times,while that before surgery was(23.97±1.28)times,the difference was statistically significant(P<0.05);after 4 weeks of surgical treatment,the patients The resting pressure of the anal canal was 19.98±8.26(mmHg),while it was(54.71±9.77)mm Hg before surgery,the difference was statistically significant(P<0.05);the patient's rectal compliance after 4 weeks of surgery was(5.25±1.16)mL/mm Hg,and(14.01±1.94)mL/mm Hg before surgery,the difference was statistically significant(P<0.05);the patient's maximum anal systolic blood pressure after 4 weeks of surgery was(63.37±28.84)mm Hg,and(120.03±25.57)mm Hg before surgical treatment,the difference was statistically significant(P<0.05);the postoperative complication rate after treatment and the half-year recurrence rate after surgery were 10.00%and 6.00%,respectively.After 4 weeks of surgical treatment,the number of patients with Kirwan's anal function rating 1 and 2 was higher than that before the surgical treatment,and the data was meaningful after comparison(P<0.05).Conclusion In the treatment of rectal cancer patients,the treatment of rectal cancer with ultra-low anastomosis preserving the anus together with targeted nursing measures can play a good role in improving the anorectal pressure and anal function of the patient,and is beneficial to improve the prognosis of the patient.