直肠脱垂患者微创手术的效果研究  

Laparoscopic versus open mesh rectopexy for rectal prolapse

作　　者：张曰涛[1] 陈秋楠[1] 刘栋[1] 

机构地区：[1]武警山东总队医院,山东济南250014

出　　处：《腹腔镜外科杂志》2016年第3期177-180,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜直肠补片悬吊固定术治疗直肠脱垂患者的临床效果,为其研究应用提供可参考的依据。方法:选择50例直肠脱垂患者作为研究对象,采用随机数字法平均分为腹腔镜组与开腹组,分别行腹腔镜直肠补片悬吊固定术(腹腔镜组)与开腹直肠补片悬吊固定术(开腹组)。对比两组患者的临床疗效。结果:腹腔镜组术中出血量、术后排气时间及住院时间均明显少于开腹组,差异有统计学意义(P<0.05)。术后腹腔镜组C反应蛋白、白介素-6、肿瘤坏死因子-α水平均低于开腹组,差异有统计学意义(P<0.05)。腹腔镜组自我效能总分、症状管理自我效能、共性管理自我效能得分高于开腹组,差异有统计学意义(P<0.05)。结论:腹腔镜直肠补片悬吊固定术治疗直肠脱垂具有更好的临床疗效及安全性,可更好地提高患者的自我效能,值得临床推广应用。Objective： To evaluate the efficacy and safety of laparoscopic versus open mesh rectopexy for rectal prolapse,in order to provide a reference basis for the research application. Methods： A retrospective review was conducted for 50 patients with rectal prolapse. All patients were divided into laparoscopy group and laparotomy group using randomly digital method. Patients with laparoscopic mesh rectopexy were in laparoscopy group,and patients with open mesh rectopexy were in laparotomy group. The differences of clinical curative effects were compared between the two groups. Results： The intraoperative blood loss,postoperative exhaust time and hospital stay in laparoscopic group were significantly lower than those in laparotomy group,the differences were statistically significant（ P 0. 05）. The CRP,IL-6,and TNF-α in laparoscopic group were significantly lower than those in laparotomy group,the differences were statistically significant（ P 0. 05）. The self-efficacy scores,symptom management self-efficacy,common management self-efficacy scores in laparoscopic group were significantly higher than those in laparotomy group,the differences were statistically significant（ P 0. 05）. Conclusions： Laparoscopic mesh rectopexy is safer and more efficient than open mesh rectopexy in patients with rectal prolapse.This procedure can better increase the self-efficacy of patients,and is worthy of clinical application.

关 键 词：直肠脱垂 直肠补片悬吊固定 腹腔镜检查 

分 类 号：R657.19[医药卫生—外科学]