改进盆膈修补和直肠乙状结肠切除吻合术治疗Ⅲ度直肠脱垂23例疗效分析  

Improved the Method of Mending the Pelvic Diaphragm and Resected the Sigmoid Colon and Rectal Anastomosis for Treatment of Ⅲ Degrees Rectum Prolapse:Analysis of 23 Cases

作　　者：张国云[1] 潘忠平[1] 葛宁[1] 张小玲[1] 

机构地区：[1]郑州大学附属郑州中心医院,河南郑州450007

出　　处：《中国医学创新》2012年第35期131-132,共2页Medical Innovation of China

摘　　要：目的：探讨改进盆膈修补方法来治疗Ⅲ度直肠脱垂手术效果。方法：2007年9月-2012年1月，对23例Ⅲ度直肠脱垂患者进行了经腹直肠乙状结肠切除及改进盆膈修补术，将直肠游离到肛提肌平面，切除冗长的乙状结肠及直肠上段，行降结肠末端一直肠端端吻合，修补肛提肌松弛所造成的盆膈薄弱区，低位缝合关闭盆底腹膜，提升盆膈。观察手术时间、出血量、并发症、复发情况。结果：23例患者手术均顺利，手术时间80．5min（75～85min），出血量65ml（55～100ml）。本组无手术死亡和腹部严重并发症发生。术后随访6个月。3年效果满意，症状无复发。结论：经腹乙状结肠直肠切除吻合加改进盆膈修补有效治愈了Ⅲ度直肠脱垂，手术安全、可操作，术后肛门功能也明显改善，可考虑作为Ⅲ度直肠脱垂及其他治疗方法复发患者的最终手术方法。Objective：To evaluate the ways to improve basin diaphragmatic repair to treat m degrees rectal prolapse operation effect.Method：From September 2007 to Juanary 2012, Application of improving the methods of mending the pelvic diaphragm and resected the sigmoid colon and rectal anastomosis to treate 23 cases of Ⅲ degrees rectum prolapse.Dissociate the rectal to the level of levator and cutoff the tedious sigmoid colon and upside of rectum and then coincide the stump of descending colon and rectum.As well as repare the weak area that is caused by the relaxation of the levator.At last, shut off abdominal membrane of the sink to asense basin diaphragmatic.The time of operation and the amount of bleeding were observed and the complication and relapse rate were analyzed.Result：The progress of operation of 23 eases is successfully, the average time of the operation is 80.5 min（ 70-85 rain ） and the hemorrhage volume is 65 ml （ 55-100 ml ） .There is no death and serious complication of the abdomen, the symptom of the rectal prolapse is not occurrence and the conquence is satisfied during 6 month to 3 years after operation.Conclusion：The cure to resected the sigrnoid colon and rectal anastomosis as well as improve the mending the pelvic diaphragm for treatment of Ⅲ degrees rectum prolapse through abdomen is efficacious.The operation is security and easy and the function of the anus is obvious improved.This operation can be considered as the final surgical method to cure m degrees rectum prolapse and other treatment in patients was unsuccessful.

关 键 词：直肠乙状结肠切除 Ⅲ度直肠脱垂 盆膈修补 

分 类 号：R657.1[医药卫生—外科学]