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目的研究部分肛门内括约肌切除的低位直肠癌保留肛门术后的排便功能。方法38例低位直肠癌患者均行部分肛门内括约肌切除。其中20例直接行结肠肛管吻合,18例行结肠J型造袋后吻合。分别于术后(28±10)周和(100±20)周用标准问卷(Wexnerscore)调查患者大便的控制功能。结果术后26.3%患者对成形大便失控,50.0%的患者对液态大便失控,失控情况至少1次/周。结肠J型造袋患者的大便控制能力犤(8.2±3.5)分犦显著强于直接吻合组犤(14.6±4.0)分犦;两组比较,P<0.05。结论肛门内括约肌的切除会导致患者术后大便控制功能的损害;结肠J型造袋能改善患者的大便控制功能。
Objective To study the defecation function of anus after resection of low rectal cancer in partial anal sphincter resection. Methods 38 cases of low rectal cancer patients underwent partial anal sphincter resection. Among them, 20 cases received colorectal anal canal anastomosis directly, and 18 cases performed colonic J-type anastomosis. Patients’ stool control function was investigated by Wexnerscore at 28 ± 10 weeks and 100 ± 20 weeks respectively. Results After operation, 26.3% of patients lost control of formed stool. 50.0% of patients lost control of liquid stool and had uncontrolled conditions at least once / week. Colonic J-shaped bag-making patients stool control 犤 (8.2 ± 3.5) points significantly stronger than direct anastomosis group 犤 (14.6 ± 4.0) points 犦; two groups, P <0.05. Conclusion Excision of anus internal sphincter can lead to postoperative bowel control dysfunction. Colon J-bagging can improve the patient’s stool control function.