考察低位直肠切除保肛手术(Dixon)联合预防性回肠造口治疗低位直肠癌的应用效果。

选取2012年7月至2016年7月低位直肠癌住院患者62例，按患者手术方式分为单纯保肛组(29例)和联合造口组(33例)。单纯保肛组患者仅接受低位Dixon保肛手术治疗，联合造口组患者在单纯保肛组基础上联合预防性回肠造口治疗。采用SPSS 18.0统计软件进行统计学处理，术后恢复情况指标、术前、术后3个月及6个月肛门功能和术后生活质量评分等计量资料以±s表示，采用独立t检验；术后并发症发生率等计数资料比较采用χ²检验。P<0.05为差异有统计学意义。

联合造口组的手术时间、恢复排气排便时间、恢复进食时间、下床时间和住院时间均明显少于单纯保肛组(P<0.05)；联合造口组的吻合口漏、吻合口狭窄发生率较低，差异均具有统计学意义(P<0.05)；手术后3个月和6个月，联合造口组的Wexner评分均明显低于单纯保肛组(P<0.05)；同单纯保肛组相比，联合造口组术后6个月排尿频率、脓血便、排便频率、排气失禁、排便失禁和焦虑评分均较低(P<0.05)。

低位直肠癌Dixon保肛手术联合预防性回肠造口可在加快患者恢复速度的同时，降低术后吻合口漏等并发症发生率，提高术后生活质量，值得在临床推广。

To investigate the application effects of sphincter preserving Dixon surgery combined with prophylactic ileostomy in low rectal cancer.

From July 2012 to July 2016, 62 cases of low rectal cancer treated in our hospital were retrospectively analyzed and were divided into sphincter preserving group (n=29) and combined ileostomy group (n=33) according to the operational manner. Patients in sphincter preserving group were only given low Dixon rectal surgery while patients in combined ileostomy group were given the same surgery combined with preventive ileostomy treatment. Statistical analysis were performed using SPSS statistical software 18.0, measurement data such as postoperative recovery index, anal function before surgery, 3 months and 6 months as well as postoperative life quality score were represented by (±s), compared with t test; the incidence of postoperative complications and count data were compared using the χ² test. The difference of P<0.05 was statistically significant.

Compared with sphincter preserving group, the operation time, exhaust time, recovery time, ambulation time and hospitalization time were significantly lower in combined ileostomy group (P<0.05). Besides, the anastomotic leakage rate and anastomotic stenosis rate were lower in combined ileostomy group, the differences were statistically significant (P<0.05); 3 months and 6 months after surgery, the Wexner score in the combined ileostomy group was significantly lower than in sphincter preserving group (P<0.05); 6 months after surgery, patients in combined ileostomy group had higher scores on urination, pus and blood stool, defecation frequency, exhaust defecation incontinence, incontinence and anxiety score (P<0.05).

Application of sphincter preserving Dixon surgery combined with preventive ileostomy can promote the recovery of patients in low rectal cancer Dixon rate, reduce the postoperative incidence of anastomotic fistula and other complications, improve the postoperative quality of life, which is worth application clinically.