经会阴修补术加合并症处理治疗直肠前突型便秘的效果观察
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摘要
为探讨经会阴直肠前突修补术加合并症处理治疗直肠前突型便秘的临床效果,将2014年1月至2017年1月河南宏力医院肛肠科收治的104例直肠前突患者,按照治疗方法的不同分为治疗组(64例)和对照组(40例)。治疗组64例,均是在经会阴直肠前突修补术的基础上,再根据不同症状分别采取以下3种方法:1)直肠黏膜内脱垂等松弛型患者,采用经会阴直肠前突修补术加直肠黏膜结扎悬吊术治疗。2)耻骨直肠肌肥厚或括约肌张力高的肛门紧张型患者,采用经会阴直肠前突修补术加长强穴挂线术治疗。3)既有肛门括约肌肥厚或括约肌张力高又合并有直肠黏膜内脱垂型患者,采取经会阴直肠前突修补术加直肠黏膜结扎悬吊术加长强穴挂线术治疗。对照组40例,均采取经会阴直肠前突修补术治疗。观察对比2组患者的手术效果及术后随访1年总有效率。结果显示,治疗组1年后随访有效率为93.7%(60/64),对照组为80.0%(38/40),P<0.05。结果表明,在经会阴直肠前突修补术的基础上,又根据症状的不同加合并症治疗,其临床效果优于单一的经会阴直肠前突修补术,具有较高的临床应用及推广价值。
This study was to investigate the effect of trans-perineal repair + complication treatment for the constipation of rectocele,divided 104 cases of this disease admitted in author's hospital(2014-01-2017-01)into treatment group( n =64) and control one( n =40) according to different therapies,i.e,in the former firstly trans-perineal repair,then basted on their different symptoms respectively:1) for internal rectal mucosa prolapse and mucosa loosening,performing trans-perineal repair+ligation & suspension of rectal mucosa;2) for anus-intense type due to puborectal muscle hypertrophic or high-tension sphincter,performing trans-perineal rectocele repair plus Changqiang point thread-drawing;3)being hypertrophic anus-sphincter or high tension sphincter associated with internal rectal mucosa prolapse,performing trans-perineal rectocele repair+Changqiang point thread-drawing + rectal mucosa ligation & suspension; meanwhile control group received alone trans-perineal rectocele repair;then,both group's surgical effect and total effective rate of 1 year-follow-up after surgery were compared.As results,treatment group was significantly higher than control group in total effective rate of 1 year-follow-up after surgery [93.7%(60/64) vs 80.0 %(38/40), P<0.05].Results show that the combined procedure adopted by treatment group is superior to alone transperineal rectocele repair.It is higher value of clinical application and popularization.
This study was to investigate the effect of trans-perineal repair + complication treatment for the constipation of rectocele,divided 104 cases of this disease admitted in author's hospital(2014-01-2017-01)into treatment group( n =64) and control one( n =40) according to different therapies,i.e,in the former firstly trans-perineal repair,then basted on their different symptoms respectively:1) for internal rectal mucosa prolapse and mucosa loosening,performing trans-perineal repair+ligation & suspension of rectal mucosa;2) for anus-intense type due to puborectal muscle hypertrophic or high-tension sphincter,performing trans-perineal rectocele repair plus Changqiang point thread-drawing;3)being hypertrophic anus-sphincter or high tension sphincter associated with internal rectal mucosa prolapse,performing trans-perineal rectocele repair+Changqiang point thread-drawing + rectal mucosa ligation & suspension; meanwhile control group received alone trans-perineal rectocele repair;then,both group's surgical effect and total effective rate of 1 year-follow-up after surgery were compared.As results,treatment group was significantly higher than control group in total effective rate of 1 year-follow-up after surgery [93.7%(60/64) vs 80.0 %(38/40), P<0.05].Results show that the combined procedure adopted by treatment group is superior to alone transperineal rectocele repair.It is higher value of clinical application and popularization.
引文
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[2]桂树松,路明.STARR联合肛管扩约肌松解术治疗女性非单纯性直肠前突30例[J]海南医学,2018,28(5):707-709.
[3]刘宝华.《便秘外科诊治指南》(2017年版)解读[J].中华胃肠外科杂志,2017,20(12):1331-1333.
[4]李卫,王园园,赵小萌,等.三术式联合治疗出口梗阻型便秘临床分析[J].河北医药,2017,39(2):221-223,226.
[5]张萍.直肠前突并直肠黏膜内脱垂68例手术治疗体会[J].实用临床医药杂志,2010.14(19):125-126.
[6]杨会举,刘佃温,刘世举.“切、注、挂”三联术治疗出口梗阻型便秘临床研究[J].亚太传统医药,2016,12(6):119-121.
[7]郭有雷,王欣,马英.直肠前突的诊治进展[J].中国肛肠病杂志,2018,38(1):60-62.