直肠癌低位前切除综合征发展轨迹的潜在类别及预测因素分析
Analysis of potential categories and predictive factors of the trajectory of Low Anterior Resection Syndrome in rectal cancer
胡海燕 1孙佳男 1张晴 1汪彦君 1王美玲 1王权 1徐雨婷 1贺婷婷 1国瑀辰1
作者信息
- 1. 吉林大学第一医院普外中心胃结直肠外科,130021长春市
- 折叠
摘要
目的:探讨中低位直肠癌患者术后12个月内低位前切除综合征(Low Anterior Resection Syndrome,LARS)发展轨迹的潜在类别及其预测因素,为实现个性化健康管理,改善患者生活质量提供参考.方法:采用前瞻性研究设计,选取 2021年 4月至 2022 年10月收治的116 例中低位直肠癌保肛手术患者为研究对象,收集患者社会人口学资料和疾病相关资料,分别在还纳术后1个月、3 个月、6 个月和12个月时对患者进行LARS评分.应用潜类别增长模型识别术后LARS发展轨迹,并采用单因素分析及Logistic回归分析不同轨迹类别的预测因素.结果:识别出中低位直肠癌患者LARS发展轨迹分为 2 个潜在类别组,分别为"轻度症状维持组"(35.3%)和"重度症状缓解组"(64.7%),术前是否行新辅助治疗、预防性造口期间是否行盆底康复治疗在两组患者中具有统计学差异(P<0.05).结论:中低位直肠癌患者术后LARS发生率较高,多数患者症状持续时间长达术后 6 个月甚至更久,LARS发展轨迹存在群体异质性,医护人员应参考患者LARS发展轨迹类别进行个性化干预,以改善LARS的发展趋势,提升患者生活质量.
Abstract
Objective:To explore the potential categories of Low Anterior Resection Syndrome(LARS)within 12 months after surgery in patients with mid-low rectal cancer and its predictive factors to provide reference for personalized health education to improve patients'life quality.Methods:A prospective study was used to select 116 patients who underwent sphincter-preserving surgery for mid-low rectal cancer from April 2021 to October 2022 as the study subjects.The socio-demographic and disease-related data of the patients were collected,and LARS scores were assessed 1 month,3 months,6 months,and 12 months after stoma surgery.The latent class growth model was used to identify postoperative LARS trajectories,and univariate analysis and Logistic regression analysis were employed to determine the predictive factors of different trajectory categories.Results:Two latent classes of LARS trajectories were identified in patients with mid-low rectal cancer,namely"mild symptom maintenance group"(35.3%)and"severe symptom relief group"(64.7%).There were statistically significant differences in the preoperative use of neoadjuvant therapy and whether pelvic floor rehabilitation therapy was performed during the preventive stoma period between the two groups(P<0.05).Conclusion:The incidence of LARS after surgery is relatively high in patients with mid-low rectal cancer,with symptoms lasting up to 6 months postoperatively or even longer in most patients.Group heterogeneity exists in LARS trajectories among different patient groups,and healthcare providers should refer to patients'LARS trajectory categories for personalized interventions to improve the outcomes of LARS.
关键词
直肠癌/低位前切除综合征/轨迹/潜在类别/护理/生活质量Key words
rectal cancer/Low Anterior Resection Syndrome/trajectory/latent class/nursing/quality of life引用本文复制引用
基金项目
吉林省财政厅医疗卫生人才专项(JLSWSRCZX2023-102)
出版年
2024
NETL
NSTL
万方数据