吻合器直肠黏膜环切术联合柱状结扎治疗直肠黏膜内脱垂型便秘的临床效果  

Clinical study of rectal mucosa prolapse treated with procedure for prolapse and hemorrhoids and the ligation of rectal mucosa

作　　者：王世贺[1] 

机构地区：[1]沈阳市肛肠医院大肠外科,沈阳110002

出　　处：《中国当代医药》2016年第9期45-47,共3页China Modern Medicine

摘　　要：目的探讨吻合器直肠黏膜环切术(PPH)加直肠黏膜松弛柱状结扎术治疗直肠黏膜内脱垂型便秘的优越性。方法选择2010年12月~2013年11月沈阳市肛肠医院大肠外科收治的88例直肠黏膜内脱垂患者,随机将患者分为三组:A组(39例)采用PPH加直肠黏膜松弛柱状结扎术;B组(23例)采用PPH;C组(26例)采用直肠黏膜松弛柱状结扎术。观察三组患者术后恢复情况,如住院时间及有无复发等。分析三组患者的临床治疗效果。结果 A组患者住院时间明显短于B、C两组,差异有统计学意义(χ_B^2=6.571,P<0.05;χC2=8.427,P<0.05),B、C两组住院时间比较差异无统计学意义(χ~2=1.014,P>0.05)。术后随访2~3年,A组无一例患者复发,复发率明显低于B组的34.78%与C组的26.92%,差异有统计学意义(χ_B^2=10.29,P<0.05;χ_C^2=7.95,P<0.05)。B、C两组复发率比较差异无统计学意义(χ~2=0.190,P>0.05)。A组总有效率(100.0%)高于B组(82.6%)与C组(88.5%),差异有统计学意义(P<0.05),B、C两组总有效率比较差异无统计学意义(χ~2=0.513,P>0.05)。结论 PPH加直肠黏膜松弛柱状结扎术治疗直肠黏膜内脱垂型便秘具有创伤小、操作方便、并发症少、恢复时问短、安全性高等优点。Objective To investigate PPH with rectal mucosa ligation relaxation column in the treatment of rectal mucosal prolapse constipation. Methods 88 patients with internal rectal mucosal prolapse,who were in department of colorectal surgery of Shenyang Anorectal Hospital from December 2010 to November 2013,were selected and randomly divided into three groups.Group A（39 cases） were treated with PPH and longitudinal ligation of rectal mucosa.Group B（23cases） were treated with PPH.Group C（26 cases） were treated with longitudinal ligation of rectal mucosa.The postoperative recovery among the three groups was observed,such as the hospitalization time and recurrence.The clinical efficacies among the three groups were compared. Results The hospitalization time of group A was significantly shorter than group B and group C,the differences were statistically significant（χB^2=6.571,P〈0.05;χC^2=8.427,P〈0.05）,while the group B and group C were not significantly different in the length of stay（χ^2=1.014,P〉0.05）.Patients were followed up for 23 years.There was no patient recurred in group A,that was significantly lower than 34.78% in group B and 26.92% in group C,with significant differences（χB^2=10.29,χC^2=7.95,P〈0.05）.The recurrence rates of the group B and group C had no significant difference（χ^2=0.190,P〉0.05）.The total efficiency of group A was 100.0%,higher than 82.6% in group B and 88.5% in group C,with significant difference（P〈0.05）.The clinical cure rates of group B and group C had no significant difference（χ^2=0.513,P〉0.05）. Conclusion PPH and rectal mucosal relaxation columnar ligation in the treatment of rectal mucosal prolapse constipation has the advantages of less trauma,easy operation,less complications,shorter recovery time,high security and so on.

关 键 词：直肠黏膜内脱垂 吻合器 直肠黏膜柱状结扎 便秘 

分 类 号：R657.18[医药卫生—外科学]