切换至 "中华医学电子期刊资源库"

中华结直肠疾病电子杂志 ›› 2021, Vol. 10 ›› Issue (05) : 556 -560. doi: 10.3877/cma.j.issn.2095-3224.2021.05.021

护理天地

低位直肠癌保肛术后康复影响因素的研究进展
马晶晶1, 朱晓萍2,()   
  1. 1. 200072 上海,同济大学附属第十人民医院胃肠外科
    2. 200072 上海,同济大学附属第十人民医院护理部
  • 收稿日期:2021-07-07 出版日期:2021-10-25
  • 通信作者: 朱晓萍

Research progress in influencing factors of rehabilitation after anus preserving surgery for low rectal cancer

Jingjing Ma1, Xiaoping Zhu2,()   

  1. 1. Department of Gastrointestinal Surgery,, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
    2. Nursing Department, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
  • Received:2021-07-07 Published:2021-10-25
  • Corresponding author: Xiaoping Zhu
引用本文:

马晶晶, 朱晓萍. 低位直肠癌保肛术后康复影响因素的研究进展[J]. 中华结直肠疾病电子杂志, 2021, 10(05): 556-560.

Jingjing Ma, Xiaoping Zhu. Research progress in influencing factors of rehabilitation after anus preserving surgery for low rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2021, 10(05): 556-560.

低位直肠癌保肛术在治愈肿瘤的同时提高了患者术后的生活质量,不仅能够有效切除肿瘤组织,而且不会造成结肠造口,在临床上已经得到越来越广泛的应用。然而低位直肠癌保肛术后患者出现疼痛、活动度受限、营养失调以及低位前切除综合征、吻合口漏等并发症的发生,严重影响患者康复的进程。本文针对低位直肠癌保肛术后康复的影响因素进行综述,为此类患者术后康复提供一定参考。

Anus preserving surgery for low rectal cancer can cure the tumor and improve the quality of life of patients after surgery, not only can effectively remove the tumor tissue, but also does not cause a colostomy, has been more and more widely used in clinical practice. However, pain, limited mobility, malnutrition, low anterior resection syndrome, anastomotic fistula and other complications occurred in patients with low rectal cancer after anus preserving surgery, which seriously affected the process of patients' recovery. In this paper, the influencing factors of postoperative rehabilitation of low rectal cancer patients with anus-preserving surgery were reviewed to provide some reference for postoperative rehabilitation of such patients.

[1]
国家消化系统疾病临床医学研究中心, 国家消化道早癌防治中心联盟, 中华医学会消化内镜学分会等. 中国早期结直肠癌筛查流程专家共识意见(2019,上海)[J]. 中华消化内镜杂志, 2019, 36(10): 709-719.
[2]
李全伟, 姬社青, 张斌,等. 低位直肠癌新辅助治疗后Dixon术与Miles术的疗效比较[J]. 中华胃肠外科杂志, 2018, 21(6): 703-705.
[3]
Siegel RL, Miller KD, Goding Sauer A, et al. Colorectal cancer statistics, 2020[J]. CA: a cancer journal for clinicians, 2020, 70(3): 145-164.
[4]
Zheng A, Duan W, Zhang L, et al. How great is current curative expenditure and catastrophic health expenditure among patients with cancer in China? A research based on "System of Health Account 2011"[J]. Cancer Medicine, 2018, 7(8): 4036-4043.
[5]
Collard M, Lefevre JH. Ultimate functional preservation with intersphincteric resection for rectal cancer[J]. Frontiers in Oncology, 2020, 10:297.
[6]
彭丽洁, 李国胜. 直肠癌保肛术后低位前切除综合征研究进展[J]. 医学研究杂志, 2021, 50(4): 13-16,42.
[7]
孟志鹏, 江波. 低位直肠癌保肛治疗的研究进展[J]. 肿瘤研究与临床, 2021, 33(2): 156-160.
[8]
张现中, 刘忠臣. 低位直肠癌精准功能保肛(PPS)时代真的来了吗?——PPS在低位直肠癌保肛中的应用与研究[J/OL]. 中华结直肠疾病电子杂志, 2020, 9(1): 2-6.
[9]
Yun JA, Yun SH, Park YA, et al. Oncologic outcomes of single-incision laparoscopic surgery compared with conventional laparoscopy for colon cancer[J]. Annals of Surgery, 2016, 263(5): 973-978.
[10]
Chen H, Ma B, Gao P, et al. Laparoscopic intersphincteric resection versus an open approach for low rectal cancer: a meta-analysis[J]. World Journal of Surgical Oncology, 2017, 15(1): 229.
[11]
张庆彤, 刘亚莉, 张旭, 等. 新辅助放化疗联合腹腔镜治疗低位直肠癌(保肛)临床疗效[J]. 中国现代普通外科进展, 2017, 20(2): 93-95.
[12]
李干斌, 韩加刚, 王振军, 等. 新辅助放化疗治疗局部进展期直肠癌疗效分析[J]. 中国实用外科杂志, 2021, 41(2): 184-189+193.
[13]
吴宣, 赵欣茹, 刘义兰,等. 护士疼痛评估循证护理实践现状及影响因素分析[J]. 护理学杂志, 2020, 35(5): 66-68.
[14]
江志伟, 李宁. 结直肠手术应用加速康复外科中国专家共识(2015版)[J]. 中华胃肠外科杂志, 2015, 18(8): 785-787.
[15]
王天龙, 黄宇光. 推动麻醉学向围手术期医学转变:《加速康复外科中国专家共识及路径管理指南(2018版)》麻醉部分解读[J]. 协和医学杂志, 2018, 9(6): 481-484.
[16]
安洋, 王奕智, 陈晓光. 加速康复外科理念下腹腔镜结直肠手术镇痛方式的研究进展[J]. 中国医师进修杂志, 2019, 42(2): 185-189.
[17]
Song J, Wei N, Zhang J, et al. Effect of dexmedetomidine combined with oxycodone patient-controlled intravenous analgesia on the levels of inflammatory cytokine in patients with rectal cancer[J]. Pakistan Journal of Pharmaceutical Sciences, 2019, 32(3 Special): 1381-1385.
[18]
李娟娟, 张丽霞, 赵丹凤,等. 多维度疼痛护理干预在晚期癌症患者中的应用[J]. 齐鲁护理杂志, 2021, 27(11): 148-150.
[19]
刘萍, 刘利, 郑炜. 全程疼痛护理干预对直肠癌癌痛患者负性情绪和服药依从性及爆发性疼痛的影响[J]. 中国肿瘤临床与康复, 2018, 25(2): 202-205.
[20]
Balvardi S, Pecorelli N, Castelino T, et al. Impact of facilitation of early mobilization on postoperative pulmonary outcomes after colorectal surgery: a randomized controlled trial[J]. Annals of Surgery, 2021, 273(5): 868-875.
[21]
王玲. 胃肠道手术后早期下床活动的护理研究进展[J]. 全科护理, 2017, 15(6): 665-668.
[22]
中华医学会肠外肠内营养学分会, 中国医药教育协会加速康复外科专业委员会. 加速康复外科围术期营养支持中国专家共识(2019版)[J]. 中华消化外科杂志, 2019, 18(10): 897-902.
[23]
Zhang K, Cheng S, Zhu Q, et al. Early versus traditional postoperative oral feeding in patients undergoing elective colorectal surgery: a meta-analysis of safety and efficacy[J]. Chin J Gastrointest Surg, 2017, 20(9): 1060-1066.
[24]
肖琪, 普彦淞, 段宝军, 等. 胃肠道恶性肿瘤手术患者不同营养筛查与评估工具的研究现状[J/CD]. 中华普通外科学文献(电子版), 2021, 15(2): 157-160.
[25]
Annicchiarico A, Martellucci J, Solari S, et al. Low anterior resection syndrome: can it be prevented?[J]. International Journal of Colorectal Disease, 2021, Aug 19.
[26]
Sakr A, Sauri F, Alessa M, et al. Assessment and management of low anterior resection syndrome after sphincter preserving surgery for rectal cancer[J]. Chinese Medical Journal, 2020, 133(15): 1824-1833.
[27]
庞雪滢, 胡少华, 王婷. 直肠癌保肛术后低位前切除综合征评估工具及护理干预措施的研究进展[J]. 解放军护理杂志, 2020, 37(5): 82-85.
[28]
Pape E, Pattyn P, Van Hecke A, et al. Impact of low anterior resection syndrome (LARS) on the quality of life and treatment options of LARS-A cross sectional study[J]. European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society, 2021, 50: 101878.
[29]
李皓. 腹腔镜下大肠癌根治术后病人生活质量的研究进展[J]. 循证护理, 2018, 4(12): 1089-1091.
[30]
刘伟峰, 洪雷鸣, 张焕虎, 等. 直肠癌保肛术后排便功能障碍的研究进展[J]. 中国医学创新, 2017, 14(33): 145-148.
[31]
Eftaiha SM, Balachandran B, Marecik SJ, et al. Sacral nerve stimulation can be an effective treatment for low anterior resection syndrome[J]. Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland, 2017, 19(10): 927-933.
[32]
Altomare DF, Picciariello A, Ferrara C, et al. Short-term outcome of percutaneous tibial nerve stimulation for low anteri or resection syndrome: results of a pilot study[J]. Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland, 2017, 19(9): 851-856.
[33]
Mccutchan GM, Hughes D, Davies Z, et al. Acceptability and benefit of rectal irrigation in patients with Low A nterior Resection Syndrome: a qualitative study[J]. Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland, 2017, 20(3): O76-O84.
[34]
Rosen HR, Kneist W, Fürst A, et al. Randomized clinical trial of prophylactic transanal irrigation versus supportive therapy to prevent symptoms of low anterior resection syndrome after rectal resection[J]. BJS Open, 2019, 3(4): 461-465.
[35]
张毅贞. 足反射区按摩对促进直肠癌低位前切除术后患者排便功能恢复的护理效果分析[J]. 首都食品与医药, 2019, 26(7): 159.
[36]
金宗英, 李志, 李五生, 等. 中医辨证熏洗在低位直肠癌保肛术式排便功能恢复中的护理应用[J]. 世界最新医学信息文摘(电子版), 2018, (103): 5-6.
[37]
吴向欣, 崔滨滨. 留置肛管与保护性造口预防直肠癌术后吻合口瘘的现状与进展[J]. 现代肿瘤医学, 2019, 27(11): 2021-2024.
[38]
Kawada K, Takahashi R, Hida K, et al. Impact of transanal drainage tube on anastomotic leakage after laparoscopic low anterior resection[J]. International Journal of Colorectal Disease, 2018, 33(3): 337-340.
[39]
FratriĆ I, RadovanoviĆ Z, RadovanoviĆ D, et al. Value of protective stoma in rectal cancer surgery[J]. Medicinski Pregled, 2016, 69(3-4): 73-78.
[1] 刘嘉嘉, 王承华, 陈绪娇, 刘瑗玲, 王善钰, 屈海花, 张莉. 经阴道子宫-输卵管实时三维超声造影中患者疼痛发生情况及其影响因素分析[J]. 中华医学超声杂志(电子版), 2023, 20(09): 959-965.
[2] 唐旭, 韩冰, 刘威, 陈茹星. 结直肠癌根治术后隐匿性肝转移危险因素分析及预测模型构建[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 16-20.
[3] 张生军, 赵阿静, 李守博, 郝祥宏, 刘敏丽. 高糖通过HGF/c-met通路促进结直肠癌侵袭和迁移的实验研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 21-24.
[4] 张焱辉, 张蛟, 朱志贤. 留置肛管在中低位直肠癌新辅助放化疗后腹腔镜TME术中的临床研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 25-28.
[5] 杨倩, 李翠芳, 张婉秋. 原发性肝癌自发性破裂出血急诊TACE术后的近远期预后及影响因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 33-36.
[6] 甄子铂, 刘金虎. 基于列线图模型探究静脉全身麻醉腹腔镜胆囊切除术患者术后肠道功能紊乱的影响因素[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 61-65.
[7] 黄汇, 朱信强. 131I治疗45岁以下分化型甲状腺癌的疗效及影响因素[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 627-630.
[8] 李婷, 张琳. 血清脂肪酸代谢物及维生素D水平与结直肠癌发生的关系研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 661-665.
[9] 付振保, 曹万龙, 刘富红. 腹腔镜直肠癌低位前切除术中不同缝合方法的回肠双腔造口术临床效果研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 684-687.
[10] 贺亮, 王松林, 周业江. 两种预防性回肠造口在腹腔镜ISR术治疗超低位直肠癌的效果对比研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 697-700.
[11] 倪文凯, 齐翀, 许小丹, 周燮程, 殷庆章, 蔡元坤. 结直肠癌患者术后发生延迟性肠麻痹的影响因素分析[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 484-489.
[12] 范小彧, 孙司正, 鄂一民, 喻春钊. 梗阻性左半结肠癌不同手术治疗方案的选择应用[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 500-504.
[13] 杨红杰, 张智春, 孙轶. 直肠癌淋巴结转移诊断研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 512-518.
[14] 马慧颖, 凡新苓, 覃仕瑞, 陈佳赟, 曹莹, 徐源, 金晶, 唐源. 磁共振加速器治疗局部晚期直肠癌的初步经验[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 519-523.
[15] 杜振双, 胡清福, 林颖艺, 张月霞, 陈美丽, 李祎祺, 王振华. 社区全科医师激励机制的影响因素分析[J]. 中华临床医师杂志(电子版), 2023, 17(08): 876-883.
阅读次数
全文


摘要