痔上黏膜环切术联合经直肠直肠前突闭式修补术治疗直肠前突临床疗效观察  

Clinical treatment observation of procedure for prolapse and hemorrhoids combined with transrectal Block for rectocele

作　　者：项雄华 卿艳平[1] 吴为明[1] 金海波[1] 蔡张愉[1] 张康为 

机构地区：[1]宁波大学医学院附属医院肛肠外科,315000

出　　处：《中国医师进修杂志》2014年第32期44-46,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨痔上黏膜环切术（PPH）联合经直肠直肠前突闭式修补术（Block术）治疗中重度直肠前突的临床疗效。方法将86例直肠前突患者按入院当天所在月份的奇偶分为A组（奇数月，采用PPH联合Block术，49例）和B组[偶数月，采用经肛门吻合器直肠黏膜切除术（STARR），37例]，比较两组患者的治疗情况。结果两组术后疼痛程度、治愈率比较差异无统计学意义（P〉0．05）；A组手术时间、术后出血率、总住院费用、患者满意度评分、术后1年前突距离均优于B组[（25．5±2．8）min比（36．8±4．6）min、2．0％（1／49）比13．5％（5／37）、（7359±580）元比（10928±610）元、（9．1±0．8）分比（8．2±0．7）分、（5．02±0．71）mm比（9．73±1．31）mm]，差异有统计学意义（P〈0．05）。结论PPH联合Block术治疗中重度直肠前突的临床疗效确切、手术创伤更小、手术更安全，更好地预防了直肠前突的复发，同时明显减轻了患者的经济压力，值得临床推广。Objective To explore the clinical treatment of procedure for prolapse and hemorrhoids （PPH） combined with transrectal Block for rectoeele （Block procedure）. Methods Eighty-six hospitalized patients with rectocele were divided into two groups according the odevity of month：A group （odd month, PPH combined with Block procedure group,49 cases） and B group [even month,stapled trans-anal rectal resection （STARR）, 37 cases 1. The treatment conditions were compared between two groups. Results There were no statistical differences in degree of postoperative pain,healing rate between two groups （P 〉 0.05 ）. The operating time,postoperative hemorrhage rate,cost of hospitalization,patient satisfaction score and reetocele depth after 1 year in A group were significantly better than those in B group [ （25.5 ± 2.8 ） rain vs. （36.8 ± 4.6） rain,2.0%（1/49） vs. 13.5%（5/37）, （7 359 ± 580） yuan vs. （ 10 928 ± 610） yuan, （9.1 ± 0.8） scores vs. （8.2 ± 0.7） scores, （5.02 ± 0.71） mm vs. （9.73 ± 1.31 ） mm] ,there were statistical differences （P 〈 0.05 ）. Conclusions PPH combined with Block procedure for rectocele had a significant clinical effect,it is a safe new method with small surgical trauma,a better choice to prevent the recurrence of rectocele, reduces the patients economic pressure obviously. So it is worth to clinical promotion.

关 键 词：直肠前突 痔上黏膜环切术 经直肠直肠前突闭式修补术 

分 类 号：R657.1[医药卫生—外科学]