目的 回顧性分析低位直腸癌保肛手術中保留植物神經與排尿及性功能的關系,并探討其護理模式的改變。
方法 將符合研究標準的低位直腸癌患者分為兩組:保肛組278例,在直腸全系膜切除基礎上加保留肛門擴約肌手術。保肛+保留植物神經組263例,在保肛手術的基礎上加保留植物神經。觀察兩組尿意恢復時間、拔除導尿管時間、下尿路感染率、殘余尿量、排尿障礙程度及男性功能分級。
結果 低位直腸癌保留肛門及植物神經組尿意恢復時間、拔除導尿管時間、殘余尿量、男性性功能障礙的發生率、排尿障礙程度均低于保肛手術組(P lt;0.05)。
結論 在低位直腸癌保肛手術基礎上保留植物神經可以改善患者排尿及性功能。
引用本文:
陳增蓉,李 卡,印義瓊. 低位直腸癌保肛手術中保留植物神經對患者排尿及性功能的影響. 中國循證醫學雜志, 2006, 06(8): 571-575. doi:
復制
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- 1. Yasutomi M. Advances in rectal cancer surgery in Japan. Dis Colon Rectum, 1997; ( Suppl10): S74-S79.
- 2. Maeda K, Maruta M, Utsumi T, et al. Matsuoka Bladder and male sexual functions after autonomic nerve-sparing TME with or without lateral node dissection for rectal cancer. Tech Coloproctol, 2003; 7(1):29-33.
- 3. Heald RJ, Husband EM, Ryall RD.The mesorectum in rectal cancer surgery ─ the clue to pelvic recurrence? Br J Surg, 1982; 69(10):613-616.
- 4. Enker WE, Thaler HT, Cranor ML, et al.Total mesorectal excision in the operative treatment of carcinoma of the rectum. J Am Coll Surg, 1995;181(4):335-346.
- 5. Maeda K, Maruta M, Utsumi T, et al. Does perifascial rectal excision (i.e. TME) when combined with the autonomic nerve-sparing technique interfere with operative radicality? Colorectal Dis, 2002; 4(4): 233-239.
- 6. Bonnel C, Parc YR, Pocard M, et al. Effects of preoperative radiotherapy for primary respectable rectal adenocarcinoma on male sexual and urinary function. Dis Colon Rectum, 2002; 45 (7):934-939.
- 7. Masui H,Ike H, Yamaguchi S,et al. Male sexual function after autonomic nerve-preserving operation for rectal cancer. Disease of Colon Rectum, 1996;39(10):1140-1145.
- 8. Maas CP, Moriya Y, Steup WH, et al .Radical and nerve preserving surgery for rectal cancer in the Netherlands: a prospective study on morbidity and functional outcome. Br J Surg, 1998;85 (1): 92-97.