叶淼 　胡志勇 　黄伟钊 　许岩 　潘甜

【摘要】 目的：觀察结肠癌患者术后排便障碍发生状况并分析其影响因素。方法：回顾性分析2020年12月-2021年2月于本院行手术治疗的90例结肠癌患者的临床资料，患者均顺利完成手术。比较术后有无排便功能障碍患者的性别、年龄、体质量、手术下缘至肛缘距离、有无进行放化疗、手术方式、有无预防性肠造口及吻合口漏，分析结肠癌患者术后排便障碍的影响因素。结果：90例结肠癌患者经手术治疗后，有26例出现排便障碍，占比为28.89%（26/90），64例排便正常，占比为71.11%（64/90）。术后排便障碍患者中手术下缘至肛缘距离<5 cm、进行放化疗、开腹手术占比均高于排便正常患者（P<0.05）;术后排便障碍患者与排便正常患者的性别、年龄、体质量、有无预防性肠造口及吻合口漏对比，差异均无统计学意义（P>0.05）。手术下缘至肛缘距离<5 cm、进行放化疗、开腹手术均为结肠癌患者术后排便障碍的独立危险因素（P<0.05）。结论：结肠癌患者术后排便障碍发生率仍较高，与手术下缘至肛缘距离<5 cm、进行放化疗、开腹手术相关，临床应针对危险因素制定干预措施，以降低患者术后排便功能障碍发生率。

【关键词】 结肠癌 排便障碍 影响因素

Occurrence and Influencing Factors of Postoperative Dysporia in Patients with Colon Cancer/YE Miao， HU Zhiyong， HUANG Weizhao， XU Yan， PAN Tian. //Medical Innovation of China， 2021， 18（34）： -175

[Abstract] Objective： To observe the occurrence of postoperative dysporia in colon cancer patients and analyze its influencing factors. Method： The clinical data of 90 patients with colon cancer who underwent surgical treatment in our hospital from December 2020 to February 2021 were retrospectively analyzed. The patients were all successfully completed the surgery. The gender， age， body weight， distance from lower surgical margin to anal margin， radiotherapy and chemotherapy， surgical method， preventive enterostomy and anastomotic leakage of patients with or without postoperative dysporia were compared， and the influencing factors of postoperative dysporia in patients with colon cancer were analyzed. Result： After surgical treatment of 90 patients with colon cancer， there were 26 cases （28.89%， 26/90） with dysporia， 64 cases （71.11%， 64/90） with normal defecation. In patients with postoperative dysporia， the proportions of the distance between the lower margin of operation and the anal margin <5 cm， chemoradiotherapy and open surgery were higher than those of normal defecation patients （P<0.05）. There were no significant differences in gender， age， body weight， preventive enterostomy and anastomotic leakage between patients with postoperative dysporia and patients with normal defecation （P>0.05）. The distance between the lower surgical margin and the anal margin <5 cm， chemoradiotherapy and open surgery were all independent risk factors for postoperative dysporia in colon cancer patients （P<0.05）. Conclusion： The incidence of postoperative dysporia in patients with colon cancer is still high， which is related to the distance between the lower margin of surgery and the anal margin <5 cm， chemoradiotherapy and open surgery. Clinical intervention measures should be formulated according to the risk factors to reduce the incidence of dysporia.

[Key words] Colon cancer Dysporia Influencing factors

First-author’s address： Fuzhou First People’s Hospital， Fuzhou 344000， China

doi：10.3969/j.issn.1674-4985.2021.34.042

结肠癌为消化道肿瘤常见类型，临床治疗以手术为主，随着手术器械不断更新及手术经验积累，结肠癌保肛率越来越高，且5年生存率高达80%左右，治疗效果确切[1-2]。虽然手术治疗利于延长结肠癌患者生存时间，但手术会对排便功能造成一定影响，降低手术效果，使得患者预后并不理想[3]。……