资源描述：
《影响低位直肠癌手术保肛相关因素的研究》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。
1、影响低位直肠癌手术保肛相关因素的研究作者：朱乃标董米连章园张锐利林祖朝王宝枝【摘要】目的分析影响低位直肠癌手术保肛的相关因素。方法将341例低位直肠癌患者按是否施行保肛手术而分为APR组和SP组，对两组病例临床资料（包括肿瘤下缘距肛缘的距离、患者年龄、性别、BMI）及病理资料（包括肿瘤周径、肿瘤位置、肿瘤大体分型、分化程度和Dukes分期）进行比较分析。结果APR组肿瘤下缘距肛缘距离显著小于SP组，肿瘤周径小于1/2周、1/2～3/4周、大于3/4周及全周四者保肛率依次下降（P＜0.01），对于肿瘤周径小于1/2周
2、者，肿瘤主体位于后壁、侧壁及前壁者三者保肛率依次下降，但无明显统计学意义（P＞0.05）。肿瘤大体分型中，肿块型、溃疡型及浸润型三者保肛率依次下降（P＜0.05），肿瘤病理呈高、中、低分化癌者三者保肛率逐渐下降（P＜0.01），低位直肠癌DukesA、B、C、D期四者保肛率呈逐渐下降趋势。青年人、男性、BMI≥23的患者其保肛率显著低于中老年人、女性及BMI＜23的患者（P＜0.05）。结论肿瘤下缘距齿状线或肛缘的距离是低位直肠癌手术保肛最主要的影响因素，肿瘤周径、肿瘤病理分期、肿瘤主体位置、肿瘤大体分型、肿瘤分化
3、程度及患者的性别及BMI等均可对低位直肠癌手术保肛产生影响。【关键词】低位直肠癌保肛手术影响因素11【Abstract】ObjectiveToanalyzetheinfluencingfactorsofsphincterpreservingoperationinlowerrectalcancer.Methods341patientswithlowerrectalcancerweredividedintotwogroupsaccordingtothemethodsofoperations:theabdominoper
4、inealresection(APR)groupandthesphincterpreserving(SP)group.Theclinicalandpathologicaldata(including:distanceoftumorlowermarginfromanaledge,age,gender,BodyMassIndex,circumferenceofintramuralspread,tumorlocation,tumormacropathologicaltype,degreeofdifferentiation
5、andDukesstage）betweenthetwogroupswerecompared.ResultsThedistanceoftumorlowermarginfromanaledgeinAPRgroupwasshorterthaninthatinSPgroup.TheSPratesinpatientswithcircumferenceofintramuralspread<1/2circle,1/2-3/4circle,<3/4circleandwholecircleweregraduallydec
6、reased(P<0.01);Amongthepatientswithtumorcircumferenceofintramuralspread<1/2circle,theSPratesinpatientswithtumorlocatedintheposterior,anteriorandlateralwerealsograduallydecreased,butthedifferencehadnostatisticsignificance(P>0.05).SignificantdifferentSP
7、ratesweredetectedindifferenttumormacropathologicaltypes(nodustype,ulcertype,infiltratingtype),andtheywereweregraduallydecreased(P<0.05),and11thesamedifferencewasfoundinhigh,medium,andpoorlydifferentiatedcancers.TheSPratesinpatientswithcancerDukes’stagingA,B
8、,C,andDweregraduallydecreased.ConclusionsThemostimportantinfluencingfactorsofsphincterpreservingoperationinlowerrectalcanceristhedistanceoftumorlowermarginfromanaledgeorthepectinat
