Abstract: Objective　To investigate the changes in bowel function in patients with middle and low rectal cancer who underwent preoperative neoadjuvant chemoradiation and prophylactic colostomy，to provide evidence of improvement in bowel function in patients with middle and low rectal cancer.Methods　The study was a prospective longitudinal study.Study subjects were chosen through a convenient sampling method.The General Information Questionaire and Chinese version Memorial Sloan-Kettering Cancer Center（MSKCC） Bowel Function Questionnaire were used to conduct the survey study.A total of 97 patients with newly diagnosed middle and low rectal cancer who received neoadjuvant chemoradiation in the Affiliated Cancer Hospital of Sun Yat-sen University between October 2015 and October 2016 completed the questionnaire survey to assess their bowel function at various time points.Results　97，92，84，84 and 82 questionnaires were sent out，at the time of enrollment（T1），1 month after preoperative chemoradiotherapy（T2），the 4th day after colostomy（T3），3 months after colostomy（T4） and 6 months after colostomy（T5），and 97，92，84，82 and 82 questionnaires were recovered respectively. The scores from the Chinese version MSKCC Bowel Function Questionnaire were（69.5±8.9），（63.9±9.0），（59.9±7.2），（63.3±9.3） and（66.3±7.5），respectively.Among them，the total score of Chinese MSKCC intestinal function questionnaire at T1 was higher than that at T2，T3，T4 and T5，the total score at T2，T4 and T5 were higher than that at T3，and the total score at T5 was higher than that at T4（P<0.05）.At T5，the scores of the frequency factor，urgency factor，dietary factor and four items describing abnormal sensation were（17.5±2.7），（17.1±2.2），（15.8±2.4） and（11.7±3.1），respectively.Conclusion　The patients with rectal cancer had the best bowel function at the time of diagnosis followed by 6 months after colostomy，and had the worst bowel function at the 4th day after colostomy.Therefore，clinicians should pay special attention to the bowel symptoms of early postoperative patients and take measures to improve bowel function and quality of life in these patients.

Key words: Rectal neoplasms, Drug therapy, Radiotherapy, Colostomy, Bowel function

摘要： 目的　探讨接受术前新辅助放化疗及预防性造口术的中低位直肠癌患者在不同时期肠道功能的变化特征，以期为制定改善中低位直肠癌患者肛门直肠功能的措施提供依据。方法　本研究为前瞻性纵向研究，采用便利抽样法选取2015年10月—2016年10月就诊于中山大学肿瘤预防中心拟接受新辅助放化疗及预防性造口术的97例初次确诊的中低位直肠癌患者，运用一般资料调查表、中文版纪念斯隆-凯特林癌症中心（MSKCC）肠道功能问卷在不同时间点 进行问卷调查，评估其肠道功能。结果　患者入组（T1）、术前放化疗结束后1个月（T2）、造口回纳术后第4天（T3）、造口回纳术后3个月（T4）及造口回纳术后6个月（T5）时分别发放问卷97、92、84、84、82份，分别回收97、92、84、82、82份，其中文版MSKCC肠道功能问卷总得分分别为（69.5±8.9）、（63.9±9.0）、（59.9±7.2）、（63.3±9.3）、（66.3±7.5）分。其中，T1时中文版MSKCC肠道功能问卷总得分T1时高于T2、T3、T4、T5时，T2、T4、T5时高于T3时，T5时高于T4时（P<0.05）。T5时便频因子得分为（17.5±2.7）分，便急因子得分为（17.1±2.2）分，排便受饮食影响因子得分为（15.8±2.4）分，排便感觉异常因子得分为（11.7±3.1）分。结论　中低位直肠癌患者在确诊时肠道功能较好，造口回纳术后6个月次之，造口回纳术后第4天肠道功能最差，因此，尤其应关注造口回纳术后早期患者的肠道症状，采取措施帮助其顺利渡过早期阶段，改善肠道功能，提高生活质量。

关键词: 直肠肿瘤, 药物疗法, 放射疗法, 回肠造口术, 肠道功能