Construction of a combined Chinese and western medicine nursing health education program for low anterior resection syndrome after rectal cancer surgery

MA Jianwen; YUE Shujin; DUAN Yi; ZHANG Changshuo; LIU Xiangdi; SU Chunxiang

doi:10.16025/j.1674-1307.2025.04.005

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Construction of a combined Chinese and western medicine nursing health education program for low anterior resection syndrome after rectal cancer surgery

更新时间：2025-06-10

- Construction of a combined Chinese and western medicine nursing health education program for low anterior resection syndrome after rectal cancer surgery
- Beijing Journal of Traditional Chinese Medicine Vol. 44, Issue 4, Pages: 414-419(2025)
- 作者机构：
  
  北京中医药大学护理学院，北京 100029
- 作者简介：
- 基金信息：
- DOI：10.16025/j.1674-1307.2025.04.005
  CLC：
- Received：25 October 2024，
  
  Published：25 April 2025
- 稿件说明：
移动端阅览
马建文，岳树锦，段熠，等.直肠癌术后低位前切除综合征患者中西医结合护理健康教育方案的构建［J］.北京中医药，2025，44（4）：414-419.

MA Jianwen,YUE Shujin,DUAN Yi,et al.Construction of a combined Chinese and western medicine nursing health education program for low anterior resection syndrome after rectal cancer surgery[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(04):414-419.
马建文，岳树锦，段熠，等.直肠癌术后低位前切除综合征患者中西医结合护理健康教育方案的构建［J］.北京中医药，2025，44（4）：414-419. DOI： 10.16025/j.1674-1307.2025.04.005.

MA Jianwen,YUE Shujin,DUAN Yi,et al.Construction of a combined Chinese and western medicine nursing health education program for low anterior resection syndrome after rectal cancer surgery[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(04):414-419. DOI： 10.16025/j.1674-1307.2025.04.005.

摘要

目的

基于临床实践，为直肠癌保留括约肌术后低位前切除综合征患者构建中西医结合护理健康教育方案，为低位前切除综合征患者的出院健康教育提供循证参考。

方法

通过文献回顾，分别检索指南、系统评价、中低位前切除综合征健康教育原始研究的相关内容，形成《低位前切除综合征中西医结合护理健康教育内容》初稿，再通过专家函询进行完善。

结果

最终构建的《低位前切除综合征中西医结合护理健康教育内容》包括11个一级条目、39个二级条目。

结论

采用文献分析法与专家函询法构建的健康教育方案，保障了方案构建过程的权威性、科学性，便于护理工作者实施标准统一的出院健康教育，提升护理质量；便于患者及其照顾者翻阅、学习与记录，具有临床实用性。

Abstract

Objective

Based on clinical practice， to construct an integrated traditional Chinese and western medicine nursing health education program for patients with low anterior resection syndrome （LARS） after sphincter-preserving surgery for rectal cancer， and to provide an evidence-based reference for discharge health education for patients with LARS.

Methods

Through literature review， guidelines， systematic reviews， an

d original studies related to health education for LARS were retrieved to form the first draft of the

Health Education Contents of Integrated Traditional Chinese and Western Medicine Nursing for Low Anterior Resection Syndrome

， which was further refined through expert correspondence.

Results

The final

Health Education Contents of Integrated Traditional Chinese and Western Medicine Nursing for Low Anterior Resection Syndrome

was constructed， including 11 primary entries and 39 secondary entries.

Conclusion

The health education program constructed by literature analysis and expert correspondence ensures the authority and scientific rigor of the program development process. It facilitates the standardized implementation of discharge health education by nursing staff， improves the quality of nursing care， and is easy for patients and their caregivers to consult， study， and record， demonstrating strong clinical practicality.

关键词

Keywords

references

BRAY F , LAVERSANNE M , SUNG H ， et al . Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA Cancer J Clin , 2024 , 74 ( 3 ): 229 - 263 .

PIENIOWSKI E , PALMER GJ , JUUL T , et al . Low anterior resection syndrome and quality of life after sphincter-sparing rectal cancer surgery: a long-term longitudinal follow-up [J ] . Dis Colon Rectum , 2019 , 62 ( 1 ): 14 - 20 .

BRYANT CL , LUNNISS PJ , KNOWLES CH , et al . Anterior resection syndrome [J ] . Lancet Oncol , 2012 , 13 ( 9 ): e403 - e408 .

中华人民共和国国家卫生健康委员会医政医管局，中华医学会肿瘤学分会 . 中国结直肠癌诊疗规范（2020年版） [J ] . 中国实用外科杂志 , 2020 , 40 ( 6 ): 601 - 625 .

NGUYEN TH , CHOKSHI RV . Low Anterior resection syndrome [J ] . Curr Gastroenterol Rep , 2020 , 22 ( 10 ): 48 .

陈璐 , 奚兴 . 基于三维质量结构评价延伸护理服务质量的研究 [J ] . 中国护理管理 , 2015 , 15 ( 6 ): 713 - 717 .

PAQUETTE IM , VARMA MG , KAISER AM , et al . The American society of colon and rectal surgeons' clinical practice guideline for the treatment of fecal incontinence [J ] . Dis Colon Rectum , 2015 , 58 ( 7 ): 623 - 636 .

EL-SHAMI K , OEFFINGER KC , ERB NL , et al . American cancer society colorectal cancer survivorship care guidelines [J ] . CA Cancer J Clin , 2015 , 65 ( 6 ): 428 - 455 .

CROESE AD , LONIE JM , TROLLOPE AF , et al . A meta-analysis of the prevalence of low anterior resection syndrome and systematic review of risk factors [J ] . Int J Surg , 2018 （ 56 ）: 234 - 241 .

SUN R , DAI Z , ZHANG Y , et al . The incidence and risk factors of low anterior resection syndrome (LARS) after sphincter-preserving surgery of rectal cancer: a systematic review and meta-analysis [J ] . Support Care Cancer , 2021 , 29 ( 12 ): 7249 - 7258 .

CHAN K , SUEN M , COULSON S , et al . Efficacy of pelvic floor rehabilitation for bowel dysfunction after anterior resection for colorectal cancer: a systematic review [J ] . Support Care Cancer , 2021 , 29 ( 4 ): 1795 - 1809 .

LIN KY , GRANGER CL , DENEHY L , et al . Pelvic floor muscle training for bowel dysfunction following colorectal cancer surgery: A systematic review [J ] . Neurourol Urodyn , 2015 , 34 ( 8 ): 703 - 712 .

VISSER WS , RIELE WW TE , BOERMA D , et al . Pelvic floor rehabilitation to improve functional outcome after a low anterior resection: a systematic review [J ] . Ann Coloproctol , 2014 , 30 ( 3 ): 109 - 114 .

MARIS A , DEVREESE AM , D'HOORE A , et al . Treatment options to improve anorectal function following rectal resection: a systematic review [J ] . Colorectal Dis , 2013 , 15 ( 2 ): e67 - e78 .

WILTINK LM , WHITE K , KING MT , et al . Systematic review of clinical practice guidelines for colorectal and anal cancer: the extent of recommendations for managing long-term symptoms and functional impairments [J ] . Support Care Cancer , 2020 , 28 ( 6 ): 2523 - 2532 .

BULFONE G , DEL NF , DEL ME , et al . Rehabilitation strategies for low anterior resection syndrome. A systematic review [J ] . Ann Ist Super Sanita , 2020 , 56 ( 1 ): 38 - 47 .

胡月星 . 直肠癌术后低位前切除综合征影响因素的Meta分析 [D ] . 呼和浩特 : 内蒙古医科大学 , 2021 .

李倩 , 汪永坚 , 王俊杰 . 艾灸对术后胃肠功能紊乱影响的Meta分析 [J ] . 护理研究 , 2017 , 31 ( 35 ): 4512 - 4517 .

GENG L , DUAN Y , LI X , et al . Comparative efficacy of mind-body exercise for depression in breast cancer survivors: A systematic review and network meta-analysis [J ] . Worldviews Evid Based Nurs , 2023 , 20 ( 6 ): 593 - 609 .

于曦 , 金飞 , 魏静文 , 等 . 低位保肛直肠癌患者采取针对其性康复训练对其术后排便功能及生命质量的影响 [J ] . 中国现代药物应用 , 2021 , 15 ( 13 ): 227 - 230 .

冯佳媛 , 方方 , 李萍 . 凯格尔运动联合水疗法对直肠癌患者术后发生低位直肠前切除综合征和生命质量的影响 [J ] . 中西医结合护理(中英文) , 2021 , 7 ( 5 ): 76 - 78 .

王华 . 对中低位直肠癌保肛术患者实施盆底肌功能锻炼改善排便功能的护理 [J ] . 实用妇科内分泌电子杂志 , 2020 , 7 ( 13 ): 93 - 94 .

盖学银 . 基于微信平台的延续护理在超低位保肛术病人院外随访中的应用 [J ] . 全科护理 , 2018 , 16 ( 33 ): 4178 - 4181 .

丁玉珍 , 孙琳 , 沈旻静 , 等 . Kegel运动联合水疗法对直肠癌患者术后发生低位直肠前切除综合征及生命质量的临床效果研究 [J ] . 中国全科医学 , 2018 , 21 ( 14 ): 1677 - 1681 .

吕丹林 . 个性化护理对低位直肠癌保肛手术患者生命质量的影响 [J ] . 数理医药学杂志 , 2016 , 29 ( 7 ): 1091 - 1093 .

单丹丹 , 李琦 , 兰天 , 等 . 排便功能训练在低位直肠癌保肛手术后患者中的应用 [J ] . 中国医药指南 , 2016 , 14 ( 15 ): 82 .

罗爱萍 , 陆凤媚 , 林雪虹 , 等 . 盆底肌肉锻炼对预防中低位直肠癌保肛术后患者暂时性大便失禁的效果研究 [J ] . 当代护士(中旬刊) , 2016 ( 3 ): 60 - 62 .

梁雪亭 , 王千心 , 孙田杰 . 高龄低位直肠癌保肛手术后患者排便功能训练的研究 [J ] . 中国医科大学学报 , 2014 , 43 ( 6 ): 512 - 514 .

YOON BJ , OH HK , LEE J , et al . Effects of probiotics on bowel function restoration following ileostomy closure in rectal cancer patients: a randomized controlled trial [J ] . Colorectal Dis , 2021 , 23 ( 4 ): 901 - 910 .

RYOO SB , PARK JW , LEE DW , et al . Anterior resection syndrome: a randomized clinical trial of a 5-HT3 receptor antagonist (ramosetron) in male patients with rectal cancer [J ] . Br J Surg , 2021 , 108 ( 6 ): 644 - 651 .

LIN YH , YANG HY , HUNG SL , et al . Effects of pelvic floor muscle exercise on faecal incontinence in rectal cancer patients after stoma closure [J ] . Eur J Cancer Care (Engl) , 2016 , 25 ( 3 ): 449 - 457 .

WEI X , YUAN R , YANG J , et al . Effects of Baduanjin exercise on cognitive function and cancer-related symptoms in women with breast cancer receiving chemotherapy: a randomized controlled trial [J ] . Support Care Cancer , 2022 , 30 ( 7 ): 6079 - 6091 .

LARKEY LK , ROE DJ , WEIHS KL , et al . Randomized controlled trial of Qigong/Tai Chi Easy on cancer-related fatigue in breast cancer survivors [J ] . Ann Behav Med , 2015 , 49 ( 2 ): 165 - 176 .

唐艳 , 李春霞 , 李静 , 等 . 低位直肠癌保肛术后早期排便功能训练对肛门功能影响的临床研究 [J ] . 心理月刊 , 2020 , 15 ( 22 ): 224 - 225 .

章晓霞 , 彭锋 , 袁小娟 . 护理干预在直肠癌术后患者中的应用 [J ] . 中国继续医学教育 , 2019 , 11 ( 18 ): 148 - 150 .

梁雪萍 . 综合盆底肌锻炼对直肠癌保肛术患者肠道功能及生命质量的影响 [D ] . 天津：天津医科大学 , 2019 .

王晓芳 , 韩立伟 , 王红 , 等 . 快速康复护理联合微信随访对低位直肠癌保肛手术患者排便功能的影响 [J ] . 中国实用医药 , 2017 , 12 ( 21 ): 164 - 165 .

杜振双 , 钟铁刚 , 林建泉 , 等 . 低位直肠癌保肛术后排便功能训练效果观察 [J ] . 中国现代普通外科进展 , 2018 , 21 ( 2 ): 126 .

杨蓉蓉 . 直肠癌前切术后失禁性皮炎护理体会 [J ] . 内蒙古中医药 , 2014 , 33 ( 34 ): 169 .

徐爱俊 . 低拉直肠癌保肛术后排便异常的护理 [J ] . 世界最新医学信息文摘（连续型电子期刊） , 2015 ( 27 ): 223 .

谭翠莲 , 王瑛 , 卢晓明 . 超低位直肠癌经括约肌间径路切除患者排便功能评估与护理 [J ] . 护理学杂志 , 2012 , 27 ( 18 ): 34 - 35 .

桂晨 . 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评价 [J ] . 结直肠肛门外科 , 2018 ( s1 ): 51 - 53 .

梁雪 . 痛泻要方内服配合十一方药渣腹部烫疗治疗肠易激综合征腹泻型75例临床观察 [J ] . 中医杂志 , 2005 ( 12 ): 913 - 914 .

DULSKAS A , AUKSTIKALNIS T , KAVALIAUSKAS P , et al . The role of traditional acupuncture in low anterior resection syndrome treatment: a pilot study [J ] . Dis Colon Rectum , 2022 , 65 ( 1 ): 93 - 99 .

LIU W , XU JM , ZHANG YX , et al . The relationship between food consumption and bowel symptoms among patients with rectal cancer after sphincter-saving surgery [J ] . Front Med (Lausanne) , 2021 （ 8 ）: 642574 .

SUN V , WENDEL CS , DEMARK-WAHNEFRIED W , et al . Diet and behavior modifications by long-term rectal cancer survivors to manage bowel dysfunction-associated symptoms [J ] . Nutr Cancer , 2019 , 71 ( 1 ): 89 - 99 .

KROUSE RS , WENDEL CS , GARCIA DO , et al . Physical activity, bowel function, and quality of life among rectal cancer survivors [J ] . Qual Life Res , 2017 , 26 ( 11 ): 3131 - 3142 .

HOU XT , PANG D , LU Q , et al . Bowel dysfunction and self-management for bowel symptoms after sphincter-preserving surgery: a cross-sectional survey of Chinese rectal cancer patients [J ] . Cancer Nurs , 2017 , 40 ( 4 ): E9 - E16 .

LANDERS M , MCCARTHY G , LIVINGSTONE V , et al . Patients' bowel symptom experiences and self-care strategies following sphincter-saving surgery for rectal cancer [J ] . J Clin Nurs , 2014 , 23 ( 15/16 ): 2343 - 2354 .

MCCUTCHAN GM , HUGHES D , DAVIES Z , et al . Acceptability and benefit of rectal irrigation in patients with low anterior resection syndrome: a qualitative study [J ] . Colorectal Dis , 2017 , 20 ( 3 ): 76 - 84 .

LU LC , HUANG XY , CHEN CC . The lived experiences of patients with post-operative rectal cancer who suffer from altered bowel function: A phenomenological study [J ] . Eur J Oncol Nurs , 2017 ( 31 ): 69 - 76 .

LIU W , XU JM , ZHANG YX , et al . The experience of dealing with defecation dysfunction by changing the eating behaviours of people with rectal cancer following sphincter-saving surgery: A qualitative study [J ] . Nurs Open , 2021 , 8 ( 3 ): 1501 - 1509 .

YIN L , FAN L , TAN R , et al . Bowel symptoms and self-care strategies of survivors in the process of restoration after low anterior resection of rectal cancer [J ] . BMC Surg , 2018 , 18 ( 1 ): 35 .

JAKOBSSON J , IDVALL E , KUMLIEN C . The lived experience of recovery during the first 6 months after colorectal cancer surgery [J ] . J Clin Nurs , 2017 , 26 ( 23/24 ): 4498 - 4505 .

SUN V , GRANT M , WENDEL CS , et al . Dietary and behavioral adjustments to manage bowel dysfunction after surgery in long-term colorectal cancer survivors [J ] . Ann Surg Oncol , 2015 , 22 ( 13 ): 4317 - 4324 .

TAYLOR C , BRADSHAW E . Tied to the toilet: lived experiences of altered bowel function (anterior resection syndrome) after temporary stoma reversal [J ] . J Wound Ostomy Continence Nurs , 2013 , 40 ( 4 ): 415 - 421 .

刘莎 , 李娅 , 徐祥 . 直肠癌保肛术后患者对肠道症状的认知程度及自我护理的调查 [J ] . 局解手术学杂志 , 2013 , 22 ( 4 ): 386 - 387 .

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