综合康复锻炼对改善低位直肠癌患者术后前切除综合征的效果
| 作者: |
1张丽,
1赵君鑫,
1刘小玉
1 郑州市中医院外科，郑州 450007 |
| 通讯: |
张丽
Email: zzhangli1971@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2017.06.030 |
摘要
目的：探讨综合康复功能锻炼对改善低位直肠癌术后患者前切除综合征(anterior resection syndrome，ARS)的护理效果。方法：选择低位直肠癌术后并发ARS的98例患者，按住院号的顺序随机分为对照组和综合组，其中对照组49例患者采取常规盆底相关肌肉力量锻炼方案；综合组49例患者采取盆底肌锻炼与神经康复锻炼，分别比较两组患者干预前及干预后1，3，6个月时两组患者的前切除综合征评分(low anterior resection syndrome score，LARSS)及生存质量情况。结果：两组在干预前和干预后1个月时LARSS评分，差异无统计学意义(P>0.05)，综合组在干预后3个月和6个月时LARSS评分明显低于对照组，差异有统计学意义(P<0.05)；两组在时间效应、组间效应及时间–组间效应值，差异均具有统计学意义(P<0.05)；两组在干预前及1个月时生活质量各维度评分，差异无统计学意义(P>0.05)；在干预后3个月和6个月时除环境功能外综合组患者的生活质量其他维度评分均高于对照组，差异有统计学意义(P<0.05)；除环境功能组间效应外，两组患者在生活质量所有指标的时间效应、组间效应及时间–组间效应，差异有统计学意义(P<0.05)。结论：通过开展盆底肌力锻炼联合神经康复锻炼较单纯盆底肌力锻炼更能够快速改善低位直肠癌术后ARS症状，对改善患者生存质量更为显著，在临床值得进一步推广。
关键词：
盆底肌力锻炼
神经康复锻炼
前切除综合征
生活质量
护理
Effect of comprehensive rehabilitation training on improving anterior resection syndrome of patients after low rectal cancer surgery
CorrespondingAuthor: ZHANG Li Email: zzhangli1971@126.com
DOI: 10.3978/j.issn.2095-6959.2017.06.030
Abstract
Objective: To explore the effect of comprehensive rehabilitation training on improving anterior resection syndrome (ARS) of patients undergoing low rectal cancer surgery. Methods: Ninety-eight patients undergoing low rectal cancer surgery complicated with ARS were selected and randomly divided into the control group and the comprehensive group according to the order of their admission numbers; the 49 patients in the control group received the conventional pelvic floor muscle training program, while the 49 patients in the comprehensive group underwent pelvic floor muscle training and neurological rehabilitation exercises; low anterior resection syndrome score (LARSS) and quality of life before intervention and 1, 3, 6 months after intervention were compared between the two groups. Results: There was no significant difference between the two groups regarding LARSS score at the time of discharge and 1 month after discharge (P>0.05), while patients in the comprehensive group had significantly lower LARSS score than those in the control group at 3 and 6 months after intervention (P<0.05). There were statistically significant in time effect, group effect and time – group effect between the two groups (P<0.05). There was no significant difference between the two groups regarding score of each dimension of quality of life at the time of discharge and 1 month after discharge (P>0.05), while after 3- and 6-month intervention, patients in the comprehensive group had higher scores of all dimensions of quality of life (except environment function) compared to those in the control group (P<0.05). Except the group effect of environmental function.There were statistically significant in the time effect, the group effect and the time*group effect between the two groups (P<0.05). Conclusion: Compared to the conventional program, pelvic floor muscle training in combination with neurological function exercises could improve ARS after rectal cancer surgery more quickly, and could bring more significant improvement to quality of life of patients; it is worth being further promoted clinically.