直肠癌保肛术前肛门功能评价的初步调查研究-中华普通外科学文献.PDF

· 2 4 1 · 中华普通外科学文献（电子版）2014 年 6 月第 8 卷第 3 期 Chin Arch Gen Surg（Electronic Edition)，June 2014，Vol.8，No.3 ·调查分析 · 直肠癌保肛术前肛门功能评估的初步 调查研究 莫健文　谢莉萍　彭慧　向军　苏丹　李丽　任东林　黄美近 　　 【摘要】　目的　探讨肛门直肠测压在中低位直肠癌保肛术前评估肛门功能的临床应用 。方法 采用肛肠动力检测系统（ARM）记录 107 例中低位直肠癌患者手术前的直肠肛管压力指标，采用向 量测压软件分析系统临床数据 。结果　中低位直肠癌患者的肛管静息压比健康者轻度升高，直肠最 小感觉阈值、初始排便阈值比健康者明显升高；不同性别患者的肛管长度、肛管最大收缩压差异有 统计学意义（P 0.05），中位及低位直肠癌患者的肛管最大收缩压差异有统计学意义（P 0.05）， 60 岁组和≥ 60 岁组的直肠癌患者的肛管静息压、肛管最大收缩压差异有统计学意义（P 0.05）。 结论　性别、年龄、肿瘤位置都是直肠癌患者肛门功能的影响因素。肛门直肠测压可以了解中低位 直肠癌患者肛门内外括约肌的情况和评估患者的持便控便能力。 　　 【关键词】　测压；直肠癌；肛门功能 Preliminary study of evaluating anal function of middle or low rectal cancer patients before anus reservation operation Mo Jianwen*, Xie Liping, Peng Hui, Xiang Jun, Su Dan, Li Li, Ren Donglin, Huang Meijin. *Department of General Surgery, Central Hospital of Kaiping City, Kaiping 529300, China Corresponding author: Huang Meijin, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangdong Gastrointestinal and Anal Hospital, Guangzhou 510655, China, Email: maymay0129@21 The first 2 authors have contributed equally to this article 　　【Abstract】　Objective　To investigate the clinical application of anorectal manometry in evaluating the anal function for middle or low rectal cancer patients before anus reservation operation. Methods　The detection system of anorectal dynamics (Laborie anorectal manometry, ARM) was used to record anorectal pressure of 107 patients with middle or low rectal cancer before operation and the clinical data was analyzed by vector pressure software. Results　The anal canal resting pressure of patients with middle or low rectal cancer was slightly higher, while the minimum perception threshold and initial defecating sensation volume were obviously higher than the healthy controls. There was a significant difference in anal length and anal maximal contractio