中低位直肠癌保肛术后患者排便功能调查及其与生活质量的相关性分析

Investigation of Defecation Function and Its Correlation with Quality of Life in Patients with Middle and Low Rectal Cancer after Anal Preservation

目的:调查中低位直肠癌保肛术后患者排便功能现状,并分析其与生活质量的相关性。方法:以2022年1月至2023年12月于我院行中低位直肠癌保肛术治疗后的50例患者为研究对象,患者均先行临时性肠造口,后行造口回纳,且已回纳1个月以上。应用一般资料调查表采集患者信息,应用中文版低位前切除综合征(LARS)评分表评定患者术后排便功能,应用欧洲癌症研究和治疗组织(EORTC)制定的生命质量测定量表(QLQ-C30)评价患者生活质量。采用Spearman相关分析法分析患者排便功能与生活质量的相关性。结果:本组中低位直肠癌保肛术后的50例患者中,无LARS 13例,轻度LARS 26例(52.0%),重度LARS 11例(22.0%)。术后LARS总评分为(22.47±3.08)分,QLQ-C30总体生活质量评分为(69.49±18.47)分,患者术后LARS总评分与QLQ-C30总体生活质量评分呈负相关,P<0.05。结论:中低位直肠癌保肛术后大部分患者存在不同程度的排便功能障碍,且排便障碍直接影响患者生活质量,临床中应关注中低位直肠癌保肛术后排便问题,提高患者生活质量。

Objective To investigate the status quo of defecation function in patients with middle and low rectal cancer after anal preservation,and to analyze its correlation with quality of life(QOL).Methods From January 2022 to December 2023,total 50 patients who underwent anal preservation operation for middle and low rectal cancer in our hospital were selected as the study objects.All patients underwent temporary proctostomy first,and then underwent reversal surgery,and had been reversed for more than 1 month.The general data questionnaire was used to collect patient information,the Chinese version of the low anterior resection syndrome(LARS)rating scale was used to evaluate postoperative defecation function,and the QOL assessment questionnaire(QLQ-C30)developed by the European Organization for Research and Treatment of Cancer(EORTC)was used to evaluate patients'QOL.Spearman correlation analysis was used to analyze the correlation between defecation function and QOL.Results Among the 50 patients with middle and low rectal cancer after anal preservation,13 cases had no LARS,26 cases had mild LARS(52.0%),and 11 cases had severe LARS(22.0%).The total LARS score was(22.47±3.08)and the total QLQ-C30 score was(69.49±18.47).The total LARS score was negatively correlated with the total QLQ-C30 score(P<0.05).Conclusion Most patients with middle and low rectal cancer after anal preservation have varying degrees of defecation dysfunction,which directly affects patients'QOL.Clinical attention should be paid to defecation after anal preservation for middle and low rectal cancer to improve patients'QOL.